Goldberg - Figure 5 - Payers
As shown in this Figure, because of the nature and severity of the disease, the duration
(potentially lifelong), and intensity of treatment, healthcare payers are going to be an
important component of the care for these patients. Since patients with FH are at high
lifetime risk of atherosclerotic CVD, payers must be expected to cover
- initial screening
- initiation of therapy with appropriate medications
- monitoring of the response to therapy
Payers should also cover appropriate drug costs; this will probably include high potency
statins as well as combination lipid drug therapy. In addition, statin intolerance problems
occur with increasing dosage levels of the statins, and some people will not be able to
take the higher statins doses necessary to get a decrease in their LDL cholesterol levels;
therefore it is important that payers also recognize and accept the need to cover other
drugs and drug combinations for patients with statin intolerance problems. Finally, LDL
apheresis and genetic testing, when appropriate, should be covered by payers as well.
Goldberg A.
J Clin Lipidol.
2011; 5(6).
