PCSK9 Inhibitors: Florida

A national data supplier reviewed PCSK9 inhibitor claims for managed care organizations in Florida from January 2017 through December 2017.

Of health plans that received at least 300 claims for PCSK9 inhibitors, the following had the highest rates of rejections:

• Federal Employee Benefit Plan – 84%
• Florida Blue – 51%
• Tricare Military Health SVC SYS – 51%
• Express Scripts – 47%

The following had the lowest rates of rejection:

• Aetna – 18%
• Humana Health Plan – 12%

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