Transcript
Announcer
Welcome to ReachMD. This medical industry feature, titled “Implementing LDL‐C—Lowering Therapy: Conversations with the Care Team,” is sponsored by Novartis Pharmaceuticals Corporation. And this program is intended for US health care professionals.
The speakers have been compensated by Novartis Pharmaceuticals Corporation for their time.
Hello and thank you for tuning into ReachMD. In today’s program, we have Dr Michael Farbaniec, Dr Emma Hegwood and care coordinator Brittany Heller joining us to discuss how they implement LEQVIO (inclisiran), therapy in their practice to help manage LDL‐C levels in patients with primary hyperlipidemia and ASCVD or increased risk of CVD.
LEQVIO injection is indicated as an adjunct to diet and statin therapy for the treatment of adults with primary hyperlipidemia, including heterozygous familial hypercholesterolemia or HeFH, to reduce lowdensity lipoprotein cholesterol or LDL‐C.
Dr Farbaniec
Hello, and thank you for joining us today.
I’m Dr Michael Farbaniec. I’m a lipid clinic director in Pennsylvania. I’m joined here today with Dr Emma Hegwood and Britt Heller, who is our care coordinator in our lipid clinic.
Ms Heller
Hi, I'm Britt Heller. I'm a registered nurse.
Dr Hegwood
I'm Dr Emma Hegwood. I'm a practicing fellow with Dr Farbaniec in the clinical world of cardiology.
So, in addition to being a cardiology fellow and working in that field, I also happen to have familial hypercholesterolemia. I am a patient that also uses LEQVIO.
Dr Farbaniec
When I first learned about LEQVIO, what really piqued my interest about the therapy option was that it was first in its class. So, it's a small interfering RNA therapy, which I've never heard of before—LEQVIO—and it selectively targets the liver to regulate LDL‐C levels. It's also administered in our offices or in other centers by a health care professional.
It's dosed twice yearly after two initial doses as a complement to statin therapy. This administration gives me confidence that we're actually getting these medications to our patients. It's very few medications where, you know, I know they're getting it because they showed up and now they're getting it. Adverse reactions in clinical trials (≥3% of patients treated with LEQVIO and more frequently than placebo) were injection site reaction, arthralgia, and bronchitis.
We’ll share some real‐world experiences of integrating LEQVIO into the health care professionals' and their office managers' practices. So let’s get started.
So, Britt, getting involved here, what were some of the things you thought about or did in order to help build LEQVIO into patient care in our practice flow?
Ms Heller
So, some of the things that we had to think about is the sheer amount of space if we were going to be able to give this medication in our clinic, because we do have a fairly small clinic and we've really never given a specialty medication in a cardiac clinic. So that was something we definitely had to think about. And on any given day, we have about 80 to 110 patients going through the clinic. So, I wanted to make sure that we had enough room and capability to actually get this medication.
There's two different options. You can either have the medication be administered in the office or you can have it at an alternate site. And we decided to do the in‐office administration and to do a buy-and‐bill portion instead of doing it through the specialty pharmacy, because it was what made the most sense for our practice.
Dr Farbaniec
So, we order and acquire LEQVIO through the authorized network of distributors. Then we schedule a patient appointment. Following that appointment, we collect coinsurance or co‐payment from the patient for the costs administration of the product. We then can submit and claim accurately and completely with the administration code and drug code.
So, Britt, how did you work through the acquisition billing process?
Ms Heller
We order the medication through our pharmacy, and it gets delivered to us the next day, and we only keep a certain amount on hand and we order enough that will last us about a month's supply, depending on how many patients we have for our lipid clinic days.
And then the day of, I make sure I go through our entire patient list. I put in all the orders, make sure they had the accurate diagnosis codes that they need in order to submit the billing appropriately and accurately.
Dr Fabaniec
One question we can often get is then can I afford this drug? So, what do we know about the cost of access to LEQVIO?
Ms Heller
I get asked on a daily basis if they are going to be able to afford the medication, and there are a couple of great options in order for them to be able to afford this medication. We bill this through the medical insurance. So, I have found, that the cost of the medication is cheaper than maybe if they did it through a prescription insurance. For traditional Medicare patients, LEQVIO doesn't require any prior authorizations, and some of those patients have supplemental plans that may require pre‐certifications. But I haven't had many that I had to do.
Dr Fabaniec
So, Dr Hegwood, can you share your experience with coverage for LEQVIO?
Dr Hegwood
So, from my perspective, we've had a lot of success with the coverage and very minimal issue, especially since it's not generally going through specialty pharmacy and we can actually do it through insurance. So, it's been a huge advantage for our patients. We have the partnership with Novartis that can help us through those things if we do encounter any hurdles. But generally, it's been a pretty easy process.
Dr Farbaniec
So, Britt, what resource and support do you have to then help you with the process of integrating LEQVIO into our practice, including support for our payer coverage and reimbursement?
Ms Heller
I have the service center who—I have a personalized person that I speak with about my patients. I submit all the benefits investigations to them and I'm going to be able to bill these patients appropriately and accurately, to make sure that there's no issues for the injection. The other option for getting patients scheduled is the service center. If they are traveling a great distance, they can go on to the site, they can speak with one of the service center reps, and they can find a local infusion center instead of having to drive, you know, X amount of hours to our clinical site to get that done. So that's a great option available to them.
Novartis offers an amazing co‐pay card program for our commercially insured patients. A lot of the times, again, that they ask me if they can afford this, when we do the benefits investigation, and they are a commercial insurance, we encourage patients to sign up for this so they may pay as little as $0 for each treatment because of how the co‐pay card program works for Novartis. The other helpful program that they have is the care program. The patients can enroll in this because it offers a dedicated support to the patients to stay on track with their treatment.
When they enroll in this, they may be contacted with their own dedicated specialists who will provide them with personalized support, including medication reminders, healthy living tips, and other tools that they could use.
Dr Farbaniec
Dr Hegwood and Britt, would you like to share one takeaway from today's session?
Dr Hegwood
Yeah, sure. So, my big takeaway, I think, is that we really have to listen to our patients and find out what their main motivators are in their treatment plan for lowering their LDL cholesterol. Given that the LEQVIO medication is really just a two injection a year medication, it really gives them a lot of ease in integrating this into their life and really taking care of their LDL. So, for me, that's the main takeaway.
Dr Farbaniec
It's dosed twice‐yearly after 2 initial doses as a complement to statin therapy.
Britt, how about you?
Ms Heller
Taking the buy‐and‐bill approach is ultimately what makes the most sense for my practice.
Dr Farbaniec
Thanks. I want to thank you so much for this discussion on LEQVIO and for sharing all of our real‐world experiences.
Announcer
Indication: LEQVIO (inclisiran) injection is indicated as an adjunct to diet and statin therapy for the treatment of adults with primary hyperlipidemia, including heterozygous familial hypercholesterolemia (HeFH), to reduce low-density lipoprotein cholesterol (LDL-C).
Important Safety Information: LEQVIO is contraindicated in patients with a prior serious hypersensitivity reaction to inclisiran or any of the excipients in LEQVIO. Serious hypersensitivity reactions have included angioedema. Adverse reactions in clinical trials (≥3% of patients treated with LEQVIO and more frequently than placebo) were injection site reaction, arthralgia, and bronchitis.
Please see LEQVIO full Prescribing Information available on this site or at LEQVIOHCP.com.
This program was sponsored by Novartis Pharmaceuticals Corporation. If you missed any part of this discussion, visit ReachMD.com/Industry Feature. This is ReachMD. Be Part of the Knowledge.
