Repatha — Medical Mutual

Established cardiovascular disease

Initial criteria

Patient age ≥ 18 years AND
Patient has had one of the following conditions or diagnoses: previous myocardial infarction or acute coronary syndrome OR angina (stable or unstable) OR past history of stroke or transient ischemic attack OR coronary artery disease OR peripheral arterial disease OR history of coronary or other arterial revascularization procedure AND
Patient meets one of the following: (a) Patient has tried one high-intensity statin therapy (atorvastatin ≥ 40 mg daily OR rosuvastatin ≥ 20 mg daily) for ≥ 8 continuous weeks AND LDL-C after treatment remains ≥ 55 mg/dL OR (b) Patient has been determined to be statin intolerant by experiencing statin-related rhabdomyolysis OR by meeting all: experienced skeletal-related muscle symptoms, symptoms occurred during trials of both atorvastatin and rosuvastatin, and symptoms resolved upon discontinuation

Prescriber confirms patient has experienced a response to therapy (e.g., reductions in LDL-C, total cholesterol, non-HDL-C, or apolipoprotein B)

1 year