Obtaining Authorization for Use of PCSK9 Inhibitors: A Care Team Forum℠

Program Overview

It took a lot of convincing for Charles to get back on medication to help lower his cholesterol—particularly because his mother, who also had high cholesterol, lived to be 100 years old. He was later diagnosed with familial hypercholesterolemia (FH) and started on a PCSK9 inhibitor (PCSK9-I) after failing several statin and non-statin therapies. Within weeks, he found himself both astounded at its efficacy but also its cost. In this interactive roundtable discussion, Charles, his doctor, and 2 other prominent clinical experts gather to deliberate over reimbursement issues surrounding the clinical use of PCSK9-Is and offer practical strategies to facilitate navigating the prior authorization and appeals process.

Credit Expired
CE Credit Expired
Expires: May 14, 2020

Target Audience

The target audience for this activity is lipidologists, endocrinologists, cardiologists, internal medicine and family medicine physicians, as well as NPs, and PAs who manage patients with hypercholesterolemia.

Educational Objectives

Upon completion of this activity, participants should be better able to:

  • Navigate payor prior authorization pathways to ensure patients receive appropriate treatment with PCSK9 inhibitors to improve outcomes

Activity Faculty

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James A. Underberg, MD, MS, FACPM, FACP, FNYAM, FASPC, FNLA (Chair)

Clinical Assistant Professor, Medicine
NYU School of Medicine and NYU Center for CV Prevention
Director, Bellevue Hospital Lipid Clinic
New York, NY

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Christie M. Ballantyne, MD

Professor and Vice Chair, Research
Department of Medicine
Director, Center for Cardiometabolic Prevention
Chief, Sections of Cardiology and Cardiovascular Research
Baylor College of Medicine
Houston, TX

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Gregory P. Hess, MD, MBA, MSc

Instructor, Department of Emergency Medicine
Drexel University College of Medicine
Adjunct Senior Fellow, Leonard Davis Institute for Health Economics
University of Pennsylvania
Philadelphia, PA

Supporter Statement

Provider Statement

Disclosure of Financial Relationships

Faculty

Planners and Managers

Method of Participation and Request for Credit

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. 

Disclaimer Statement

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. 

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