PRALUENT is the exclusive branded PCSK9 inhibitor for CVS and Aetna commercial patients.

Learn about copay options available to commercially insured patients.

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PRA.21.10.0002

PRALUENT is covered by a majority of health plans and covered by most Medicare Part D insurance plans*

  • Most Medicare patients can expect to pay between $25 and $150 per month†
  • Eligible commercially insured patients may pay as little as a $25 copay for PRALUENT each month up to a maximum annual amount of $3500 (restrictions apply)‡

*Formulary data are provided by Managed Markets Insights & Technology, LLC (MMIT) and are current as of August 2020. Because formularies do change and many health plans offer more than one formulary, please check directly with the health plan to confirm coverage.

†Subject to plan adoption and tier placement determination.

‡Eligible patients with commercial insurance not funded through a government healthcare program such as Medicare, Medicaid, or TRICARE are subject to program terms and restrictions.

PRALUENT is empowering more:

Accessibility

Simplified prior authorization process for some plans1

Affordability

Financial assistance for eligible patients

Flexibility

2 powerful dosing options in adults with established CV disease§
§Based on patient’s efficacy needs.

DOSING INFORMATION IN ADULTS WITH ESTABLISHED CARDIOVASCULAR DISEASE

The recommended starting dose of PRALUENT is 75 mg once every 2 weeks or 300 mg once every 4 weeks (monthly) administered subcataneously. If the LDL-C response is inadequate, the dosage may be adjusted to 150 mg administered every 2 weeks.

Programs to help patients pay for PRALUENT

Commercially insured patients
Commercially insured patients

As little as a $25 copay for PRALUENT each month||¶

The MyPRALUENT® Copay Card Program may help eligible, commercially insured patients with out-of-pocket costs for their PRALUENT treatments, including deductibles, copays, and coinsurance.

  • The MyPRALUENT® Copay Card can be used yearly
  • Patients can submit for reimbursement if they paid their copay in full within 90 days

||Eligible patients with commercial insurance not funded through a government healthcare
program such as Medicare, Medicaid, or TRICARE are subject to program terms and restrictions.

Subject to a maximum annual copay assistance amount from MyPRALUENT® of $3,500.

PATIENT COPAY ENROLLMENT
Uninsured and Medicare patients who meet income restrictions

Are your patients eligible? Click below to register and submit the MyPRALUENT® Patient Assistance Program (PAP) form electronically. For questions, contact 1-844-PRALUENT (1-844-772-5836). If your patient is eligible and approved, your patient's prescription will be forwarded to the PAP pharmacy for processing.

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Low-income Medicare patients
Low-income Medicare patients

If your patients are faced with limited income and resources, there's a US government-funded program that may help pay some of their Medicare prescription drug costs. It's called the Extra Help Program and it offers:

  • Reduced Medicare Part D premiums
  • No cost share in the coverage gap or "donut hole"
  • Lower drug copays
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Clinical documentation and prior authorization (PA) tips

Many health plans require a PA for PRALUENT. Here are some helpful tips to keep in mind when gathering your patient’s clinical information and preparing a PA submission.

Items to include when submitting a PA

Statement of Medical Necessity
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Clinical documentation

Important patient information to collect:

Specific ICD-10 codes and details to support your patient’s diagnosis

Complete history of lipid-lowering therapy, including doses, frequency, and dates of use

  • Be sure to include proof of maximally tolerated high-intensity statin(s) if required
  • Also note if your patient tried and failed on ezetimibe

Contraindications or any intolerance/adverse reactions to lipid-lowering therapies

Lab work within the last 30 days showing lipid profile test results

Documentation of family history and any comorbid conditions

Proof of lifestyle modification (eg, diet, exercise, smoking cessation counseling)

Completed and signed plan-specific PA form

Prior Authorization Tips for PRALUENT

Download Tip Sheet

Before submitting any documentation to the health plan, be sure that it’s accurate and up to date to avoid unnecessary denials.

Getting patients started

iAssist is an electronic platform that simplifies access to help get PRALUENT to appropriate patients. This free, all-in-one tool:

Sends prescriptions and completed prior authorization forms directly to the pharmacy and payer

May help reduce incomplete prior authorization submission

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INDICATIONS AND USAGE

PRALUENT® (alirocumab) is indicated:

  • to reduce the risk of myocardial infarction, stroke, and unstable angina requiring hospitalization in adults with established cardiovascular disease.
  • as an adjunct to diet, alone or in combination with other low-density lipoprotein cholesterol (LDL-C) lowering therapies in adults with primary hyperlipidemia including heterozygous familial hypercholesterolemia (HeFH) to reduce LDL-C.
  • as an adjunct to other LDL-C-lowering therapies in adults with homozygous familial hypercholesterolemia (HoFH) to reduce LDL-C.
Important Safety Information
  • PRALUENT is contraindicated in patients with a history of a serious hypersensitivity reaction to alirocumab or any of the excipients in PRALUENT. Hypersensitivity reactions, including hypersensitivity vasculitis, angioedema, and other hypersensitivity reactions requiring hospitalization, have been reported with PRALUENT treatment. If signs or symptoms of serious allergic reactions occur, discontinue treatment with PRALUENT, treat according to the standard of care, and monitor until signs and symptoms resolve.
  • The most commonly occurring adverse reactions in clinical trials in primary hyperlipidemia (including heterozygous familial hypercholesterolemia (HeFH)) (≥5% of patients treated with PRALUENT and occurring more frequently than with placebo) are nasopharyngitis, injection site reactions, and influenza.
  • The most commonly occurring adverse reactions in the cardiovascular outcomes trial (>5% of patients treated with PRALUENT and occurring more frequently than placebo) were non-cardiac chest pain, nasopharyngitis, and myalgia.
  • In the primary hyperlipidemia (including HeFH) clinical trials, local injection site reactions including erythema/redness, itching, swelling, and pain/tenderness were reported more frequently in patients treated with PRALUENT 75 mg and/or 150 mg every 2 weeks (7.2% versus 5.1% for PRALUENT and placebo, respectively). Few patients discontinued treatment because of these reactions (0.2% versus 0.4% for PRALUENT and placebo, respectively), but patients receiving PRALUENT had a greater number of injection site reactions, had more reports of associated symptoms, and had reactions of longer average duration than patients receiving placebo.
  • The once-monthly (Q4W) 300mg dosing regimen had a higher rate of local injection site reactions as compared to PRALUENT 75mg Q2W or placebo (16.6%, 9.6%, and 7.9%, respectively). The discontinuation rate due to injection site reactions was 0.7% in the 300 mg Q4W arm and 0% in the other 2 arms.
  • In a cardiovascular outcomes trial, local injection site reactions were reported in 3.8% of patients treated with PRALUENT versus 2.1% patients treated with placebo, and led to permanent discontinuation in 0.3% of patients versus <0.1% of patients, respectively.
  • In the primary hyperlipidemia trials, liver-related disorders (primarily related to abnormalities in liver enzymes) were reported in 2.5% of patients treated with PRALUENT and 1.8% of patients treated with placebo, leading to treatment discontinuation in 0.4% and 0.2% of patients, respectively. Increases in serum transaminases to greater than 3 times the upper limit of normal occurred in 1.7% of patients treated with PRALUENT and 1.4% of patients treated with placebo.
  • In the primary hyperlipidemia trials, the most common adverse reactions leading to treatment discontinuation in patients treated with PRALUENT were allergic reactions (0.6% versus 0.2% for PRALUENT and placebo, respectively) and elevated liver enzymes (0.3% versus <0.1%).
  • PRALUENT is a human monoclonal antibody. As with all therapeutic proteins, there is a potential for immunogenicity with PRALUENT.
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Important Safety Information
  • PRALUENT is contraindicated in patients with a history of a serious hypersensitivity reaction to alirocumab or any of the excipients in PRALUENT. Hypersensitivity reactions, including hypersensitivity vasculitis, angioedema, and other hypersensitivity reactions requiring hospitalization, have been reported with PRALUENT treatment. If signs or symptoms of serious allergic reactions occur, discontinue treatment with PRALUENT, treat according to the standard of care, and monitor until signs and symptoms resolve.
  • The most commonly occurring adverse reactions in clinical trials in primary hyperlipidemia (including heterozygous familial hypercholesterolemia (HeFH)) (≥5% of patients treated with PRALUENT and occurring more frequently than with placebo) are nasopharyngitis, injection site reactions, and influenza.
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