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Praluent (alirocumab)United Healthcare

Homozygous familial hypercholesterolemia (HoFH)

Initial criteria

  • Diagnosis of homozygous familial hypercholesterolemia
  • Patient is receiving other lipid-lowering therapy (e.g., statin, ezetimibe, LDL apheresis)
  • Not used in combination with another proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor [e.g., Repatha (evolocumab)]
  • Not used in combination with Juxtapid (lomitapide)

Reauthorization criteria

  • Documentation of positive clinical response to Praluent therapy
  • Not used in combination with another proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor
  • Not used in combination with Juxtapid (lomitapide)

Approval duration

12 months