PCSK9 Inhibitors: National Report Card

A national data supplier reviewed PCSK9 inhibitor claims for Medicare, Medicaid, Medicaid managed care, and commercial managed care organizations across the nation from January 2018 through December 2018.

Of national health plans that received at least 3,000 claims for PCSK9 inhibitors, the following had the highest rates of rejection:

  • Federal Employee Benefit Plan – 76%
  • United Health Group – 72%
  • Express Scripts – 67%
  • CVS Health – 54%

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