New Drugs For Lowering Cholesterol

The Food and Drug Administration (FDA) recently approved two new drugs for lowering LDL, the "bad" cholesterol. The new drugs work by an entirely different mechanism from the current gold-standard cholesterol lowering drugs, the statins. The new drugs mimic the effect of a genetic mutation, described in two patients several years ago, that results in very low LDL levels (see this blog July 18, 2013). The two drugs, Praluent, made by Sanofi Regeneron, and Repatha, made by Amgen, should be available soon.

Now for the bad news; the new drugs will cost upwards of $14,000 a year. For most patients who need of a cholesterol-lowering drug, there will be no reason to switch from a statin to one of the new drugs. But some patients say (rightly or wrongly) that the statins cause them to have muscle pain, hazy memory, and problems sleeping.

Should health insurers pay for the new (expensive) drugs just become some patients say they can't tolerate the statins? Double blind studies have shown that patients taking statins have no more muscle pains than patients taking a placebo. Muscle pain is such a common complaint in the age group of patients likely to be taking cholesterol-lowering drugs that it's hard to pinpoint the source.

I guess the question is, should patients' perceptions trump good science? Or should the insurance companies just say "no"?