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donlynn avatar

Repatha, side effects and what comes next?

Heart & Blood Health | Last Active: 5 days ago | Replies (80)

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Thanks, Janell, for bringing up Inclisiran. My doctor prescribed it but Medicare would not pay until I had tried Repatha first. So essentially some Medicare bureaucrats prescribed Repatha for me, and my doc « agreed » to the Reptha or nothing decision. I read that Inclisiran has fewer side effects than Repatha. I guess the Medicare people read that too, but decided that people like me should undergo greater risk of side effects rather than lesser risk. Thanks a lot, Medicare. I wonder whether there are any lawsuits against the people who made this terrible decision. If a patient died of Repatha side effects, would that be maybe second degree murder? Practicing medicine without a license? Lawsuits and criminal charges?

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Replies to "Thanks, Janell, for bringing up Inclisiran. My doctor prescribed it but Medicare would not pay until..."

I plan to ask my doctor to prescribe Leqvio (inclisiran) and was interested to see comments about Medicare lack of coverage. According to the CMS.gov website showing drug pricing, (https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files) Part B (not Part D drug plans) does cover Leqvio, although I'm not sure if Advantage Plans might not put restrictions (such as requiring Repatha step therapy). So it appears that Medicare itself is not obstruction. I guess I'll find out of Traditional Medicare also requires step therapy prior to covering inclisiran. I'm curious if others on Medicare who take inclisiran have other experiences with this drug.