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Inclisiran Injections for Cholesterol

Heart & Blood Health | Last Active: 1 day ago | Replies (38)

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Profile picture for Janell, Volunteer Mentor @jlharsh

@tiburon I can understand your frustration. I’ve also been through the denial process with my insurance company, and I know how complicated it can become.

Did your insurance company explain the specific reason for the second denial? That may help clarify what options are available next.

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Replies to "@tiburon I can understand your frustration. I’ve also been through the denial process with my insurance..."

@jlharsh , @dlkreps, @tiburon Hi Everyone I thought I would share my recent journey getting approved for Repatha. A bit about my numbers and medications. I was told maybe a year ago that due to my Heart transplant they wanted my LDL as low as possible. Which as i found out later there shooting for under 55. Ive been around 60-80 most of the time over my life and at one point was over 100 maybe 10 years ago. Back then i started on Simvastatin the highest dose and found I got sever cramps in my calves. I could alleviate the pain by standing up and putting weight on the leg but it became so frequent it even woke me up. So my doctor took me off it and I tried using dieting more.

Then comes the era that my heart was becoming worse with rhythm problems had a pacemaker and de-fibulator. While dealing with that we were not watching the cholesterol as much (at least i wasn't) and 8 years ago I ended up at Mayo Phoenix and received a Heart transplant.
Well now the discussion about LDL returned and Mayo started me on Atorvastatin this one I've been on now for 8 years and i still get that leg cramp once in a while but a lot less often maybe every few months and the same trick still works plus it only happens once i wake up in the morning. So that i can deal with.

Now recently they found a heart artery with a 70 % blockage and put in a stent. This prompted my PCP to check other areas in my neck and we found another blockage less than 50 %. So Mayo at this point has put me also on Ezetimibe 10 MG daily and got me approved for Repatha shot every 2 weeks. I'll be seeing my Doctors over the next 2 weeks and another Lipids lab will be run on the 30th. My last labs taken before the Repatha was at 66 so ill see soon how the Repatha is doing.

I don't know for sure how Mayo got approval but I was told by a nurse that typically to get approved for Repatha they need a history on a statin to show how your doing and im guessing maybe the discovery of the blockage helped also. So i hope that may help in getting approved for what ever you may need to get approved. Ill let you know what my numbers are after the 30th.
Have a Blessed Day