OT. Anybody using PRALUENT cholesterol lowering drug?

I have been on Repatha for the last 3 years.In July Aetna advised that they will no longer cover it.I was able to get a 90 day supply in time.But after my last two shots I'm going to have to change to Praluent.The cost of Repatha had come down to $10.00 per month(2 shots).My LDL has been steady at 18 and HDL at 49.I haven't had any symptoms indicating a need for a stent since I've been on it.I've had 13 stents and 5 bypasses.If Repatha had been available in 2000 when I got my first stent I could have avoided all the others.
I hate to change but without insurance coverage its going to be expensive.
Praluent works similar to Repatha in that it blocks PSK9 protean.But Repatha claims that a statin is not necessary and that patients have had their blockages reduced.Praulent is used with a statin.
So is anybody on it?

Try "The Peoples Pharmacy" website

ratbldr427 said:

I have been on Repatha for the last 3 years.In July Aetna advised that they will no longer cover it.I was able to get a 90 day supply in time.But after my last two shots I'm going to have to change to Praluent.The cost of Repatha had come down to $10.00 per month(2 shots).My LDL has been steady at 18 and HDL at 49.I haven't had any symptoms indicating a need for a stent since I've been on it.I've had 13 stents and 5 bypasses.If Repatha had been available in 2000 when I got my first stent I could have avoided all the others.
I hate to change but without insurance coverage its going to be expensive.
Praluent works similar to Repatha in that it blocks PSK9 protean.But Repatha claims that a statin is not necessary and that patients have had their blockages reduced.Praulent is used with a statin.
So is anybody on it?

Click to expand...

Have you checked the pharmaceutical website yet. I have some meds that even with insurance they are too expensive yet the maker has a savings you can sign on for and it is quick too and cost is much less. You can do it on your phone and right there show the number to the pharmacy that covers it. I don’t know if you might have that option but check on that it might be available.

So, first, please, please, please ask your doctor about stuff like this.

I'm not a doctor, but I do research in pharma. So the following is my understanding and not medical advice (see sentence 1)
Both Repatha and Praluent work by inhibiting PCSK9. Both have had extensive clinical trials, and both appear to lower CV risk.
PCSK9 inhibitors work differently than statins, and for people who have high CV risk (I think you qualify here) and don't respond well to statins, these drugs are very beneficial.

The upshot: if Repatha works for you now, Praluent SHOULD work well for you. Just so you understand the background, there have been intense legal battles between Amgen on one side (Repatha) and Sanofi/Regeneron (Praluent) on the other. Praluent has a wholesale cost, without discounts, of $14,600 per year, while that of Repatha is $14,100 per year. Amgen apprently discounts Repatha, so it's net price ranges between $7,700 and $11,200 a year. Given your new plan's move to Praluent, I'd suspect that the actual cost to the insurer is also discounted for Praluent.

If it were me, I'd check with my doc and if there were no counterindications and your doc approves, give Praluent a try. Your doc will monitor the numbers and hopefully you and he or she will notice very little difference.

Good luck.

BTW
Your body uses, synthesizes, and moves around various lipids. The major players are triglycerides, and cholesterol. Basically:
Your liver absorbs triglycerides and cholesterol, and also synthesizes them. Statins limit the rate at which your liver synthesizes cholesterol.
(as an aside, statins also can have negative effects on muscle synthesis and can promote muscle degradation).
The liver packages TG and cholesterol into little particles called Very Low Density Lipoproteins (VLDL) and releases VLDL to the blood.
Your tissues (mainly muscle and adipose) use an enzyme called LPL to nibble triglyceride molecules off the VLDL.
This nibbling turns TG into glycerol and Non-Esterified Fatty Acids (NEFA) which are absorbed in the tissue.
The nibbling also makes the VLDL particles smaller, with lower TG content and higher cholesterol content.
These smaller particles are called Intermediate Density Lipoproteints (IDL).
The same thing happens to IDL. TG is stripped off to form Low Density Lipoprotein, or LDL.
LDL has high cholesterol content and high LDL is associated with plaque formation ("hardening of the arteries") and cardiovascular issues
LDL particles are reabsorbed into the liver by LDL receptors (LDLR) that glom onto LDL particles and then pull the LDL into liver cells.
Two key points:
1) LDLR pulling LDL into the liver cells lowers plasma cholesterol
2) LDLR continually circulate from the liver cell's surface, where they can remove LDL, into the liver cell interior, where they cannot.
PCSK9 promotes the internalization of the LDL receptors, thus lowering their ability to lower LDL.
PCSK9 inhibitors block this effect, leaving more LDLR on the surface of your liver cells.

One other thing. HDL (high density lipoprotein) particles are derived from dietary intake and start with some TG and some cholesterol. HDL scavenge cholesterol from the tissue, and exchange their TG for cholesterol in VLDL and IDL. HDL doesn't form plaque like LDL does, and so HDL acts to remove harmful cholesterol from VLDL, IDL, and LDL particles. This results in lower "bad" (LDL) cholesterol. Which is why HDL is "good" cholesterol.

bosleyjr, I responded really well from statins but hit the wall at 160 total.My GP just sent in a prescription in for Praluent and I went online and got a discount coupon from Singlecare.So Monday I'll see what it costs.
I am fortunate in that I'm not allergic to just about any thing and am a good responder to drugs.However this last week was a killer as far as muscle pain.So I'm a little leery about the statins although the latest blood work shows no liver problems.

There is another newer drug out(Inclisiran) that after a few initial high dose shots thereafter you only need one shot every 6 months,but must be administered by a doctor. It breaks down PSK9 differently than Repatha and Praluent.
I just got spoiled by the $10 a month cost,$120.00 yr not $14,000.
I can't believe that there are so many people with the same problem as me that their doc's don't recommend these drugs.

From what I understand Inclisran actually breaks down PSK9 in stead of just inhibiting it.

The thing about statins and muscle pain isn't to stop taking them. Titrate the dose lower in stages until the muscle pains go away. Get all the benefit you can from the statins because they are so cheap.

Not a doctor. Don't play one on TV. Just been on statins since 2006 (and amlodipine and lisinopril. plus the antidepressants and insulin from longer ago ) and had to adjust the dose a couple of times.