A new survey from Sanofi has found thatjust 6% of cardiologists are currently prescribingproprotein convertase subtilisin/kexin type-9 inhibitors (PCSK9is), despite 97% of them stating they are satisfied with their ability to reach patient lipid treatment goals.
In the new survey, the company explored the key barriers prohibiting the inhibitors from being prescribed, and found that infrequent lipid testing, lower interest in cholesterol management compared to acute cardiovascular events and no clear treatment "manager" were the most prevalent responses.
More specifically, over half (58%) of cardiologists surveyed believe that patients should be given lipid tests at least once every three months, yet three quarters (75%) acknowledge that it currently happens less frequently than this.
Further, when asked to rate treatment goals by interest, 77% of cardiologists surveyed said they were more interested in managing acute cardiovascular events compared to managing elevated LDL-C levels. Management of acute cardiovascular events at admission was rated of greatest interest.
As for not having a clear treatment "manager", 63% believe interventional cardiologists have primary responsibility at admission; 37% stated that non-interventional cardiologists have primary responsibility at follow-up; and 56% said the GP has primary responsibility for the ongoing management – thus bringing about confusion.
The company confirmed that the findings are in line with the National Institute for Health and Care Excellence (NICE) innovation scorecard, which highlights that uptake of PCSK9is was 77% lower than expected between January 2018 and December 2018, equating to around 8,880 eligible patients not receiving PCSK9i that year.
The results are “interesting” and confirm that “despite the overwhelming majority of cardiologists believing PCSK9is may provide benefits for eligible patients, there are barriers preventing them prescribing” explained professor Zaman, professor of cardiology at Newcastle Hospital.
He continued, “Through increasing the frequency of lipid testing, raising the priority of cholesterol management as a treatment goal and establishing clear responsibilities among the multidisciplinary team, we can make steps to improving the management of high cholesterol.”
PCSK9is were recommended by NICE in 2016 for patients treated with maximally tolerated lipid-lowering therapies, but who still require additional treatment to lower LDL-C to recommended goals.