Atomo’s advanced analytics can address market access and prior authorization issues in medical conditions served by many therapies. Our most recent work has just been published!
Atomo Impact
Measuring the Impact of Restrictive Prior Authorization Policies with Real World Data
Restrictive Utilization Management and Prior Authorization policies have significant unintended consequences. In the study detailed below, we show that cardiovascular event rates (e.g. Myocardial Infarctions, Ischemic Strokes, Revascularization) were significantly higher for individuals who did not have access to PCSK9i therapy.
Real World Evidence From Our Observational Study
In this study, we investigated individuals who were prescribed a PCSK9i. These individuals have cardiovascular events at a rate of 7 times greater than the general population.
- We found that these medications were prescribed to individuals at high risk for cardiovascular events.
%
Rejection Rate
However, PCSK9i therapy was rejected 63% of the time for these high risk groups.
Over 200,000 individuals who were at high risk of cardiovascular events were subjected to a higher risk
- 161,169 individuals between Aug 2015 – Dec 2018 were subjected at a 16% greater risk by their PCSK9i being rejected by payers
- 48,814 individuals between Aug 2015 – Dec 2018 were subjected at a 21% greater risk by not accepting their PCSK9i prescription
Leveraging Real World Evidence to Identify High Needs Populations
Randomized Controlled Trials (RCT) are the gold standard to assess efficacy. Yet researchers are often forced to study a highly selected and homogeneous study population which may not reflect a real world clinical setting. Observational studies are an affordable, timely complement that better reflects the impact of policies in a real world setting.
Business questions/challenges this proven process can address:
- How do we leverage Real World Data to quantify the impact of our therapies?
- Are there viable complements to randomized clinical trial data to generate credible evidence for Health Economic and Outcomes Research (HEOR)?
- How can Real World Evidence be utilized to optimize market access?
- How can I push back on restrictive payer policies to gain appropriate market access?
- How can real world data be used for value-based payment models?
- How do we use real world data to measure the impact of policy and practice?
Media Coverage
Familial hypercholesterolaemia: evolving knowledge for designing adaptive models of care
New PCSK9 Cholesterol Drug Faces Tough Foe. (Hint: Not Cholesterol.)
Individuals Had More Heart Attacks and Strokes When Cholesterol-lowering Drug Prescription Was Rejected or Unfilled
Thwarted Access to PCSK9 Inhibitors Linked to Greater Risk of Major CV Events
Individuals Had More Heart Attacks and Strokes When Cholesterol-lowering Drug Prescription Was Rejected or Unfilled
Access to Prescribed PCSK9 Inhibitors and CV Outcomes
Are decisions on funding of PCSK9 inhibitors affecting cardiovascular outcomes?
PCSK9i Prescription Access Disparities Linked to Cardiovascular Outcomes
Higher Price of Cholesterol Drugs Also have A High Cost to Mortality Risk
CV Risk Rises When Payers Deny Alirocumab, Evolocumab Coverage
Effect of Access to Prescribed PCSK9 Inhibitors on Cardiovascular Outcomes
Rejected Or Abandoned Cholesterol Drug Prescriptions Tied To More Heart Events
Patients have higher risk of heart problems when insurance companies reject their prescriptions
Rejected and Unfilled Prescriptions for New, More Expensive Cholesterol Drugs Tied to Higher Heart, Stroke Risk
PCSK9i and the Impact of Cost on Treating Hypercholesterolemia
PCSK9 Inhibitors Prior Authorization
Higher Cost of New Cholesterol Drugs Putting Patients at Risk: Study
Rejected, Unfilled PCSK9 Inhibitor Prescriptions Linked to Higher Risk of Cardiovascular Events
Heart Attack Risk Rises with Price of Cholesterol-lowering Drug, Study Says
Patients Denied Access to PCSK9 Inhibitors Have Worse Cardiovascular Outcomes
High-risk patients unable to take PCSK9 inhibitors have poor outcomes
Insurers reject 2/3 of high-risk PCSK9i candidates
People experienced more cardiovascular events when unable to obtain their LDL-cholesterol drug
Heart attacks, strokes increase when patients can't afford newer cholesterol drugs
Consequence of PCSK9 Rejection; Plasticizers' Effect on Heart; Arrhythmia Gene Tx
Heart disease increases when patients cannot afford newer cholesterol drugs
Heart attacks, strokes increase when patients can't afford newer cholesterol drugs
CV Event Risk Up With Rejected, Abandoned PCSK9i Prescriptions
PCSK9i and the Impact of Cost on Treating Hypercholesterolemia
Rejected and unfilled prescriptions for new, more expensive cholesterol drugs tied to higher heart, stroke risk
More heart attacks and strokes when cholesterol-lowering prescription rejected or unfilled
American Heart Association reports Rejected, Unfilled Prescriptions for new, more expensive Cholesterol Drugs tied to higher Heart, Stroke Risk
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