Man makes major strides in health after doctor appeals for insurance to cover cost
Cost remains high for inhibitors on market for years
HOUSTON – There was a time when peripheral artery disease started to rob Murray Zedeck of the things he enjoyed doing.
"It kind of changed my life, because I couldn't do a lot of walking," he said. "I used to jog. I was a runner."
His doctor prescribed an oral statin medication, but Murray couldn't tolerate the side effects.
"I went through every statin," Zedeck said. "Every brand name you could try, I went through and I couldn't take it."
That's when Dr. Paul Jellinger suggested an injectable medication called Repatha, which is part of a class of drugs known as PCSK9 inhibitors.
"It occurred to me it was not a statin, and if we could lower his bad cholesterol enough, maybe his circulation, his arteries would improve," Jellinger said.
Though these inhibitors have been on the market for years, the cost of the medication remains high, which means some insurance companies don't want to pay for it and some patients in need struggle to get it.
"Patients who are very much ideal candidates have been denied these drugs for reasons that are not clear," Jellinger said.
Through several appeals, Jellinger was able to get Murray's insurance company to cover the cost. Within a matter of weeks, he was walking again with ease.
"It's been a life-changer for me in that sense," Zedeck said. "It made a big difference."
Drug manufacturers have programs to help offset the cost of these drugs, which have to be taken indefinitely. This class of new drugs is only for patients who have dangerously high cholesterol levels that can't be controlled by any other medications.
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