Repatha® (evolocumab) CVS Caremark

Approved Use

Repatha^® is an injectable prescription medicine used:

in adults with cardiovascular disease to reduce the risk of heart attack, stroke, and certain types of heart surgery. READ MORE
along with diet alone or together with other cholesterol-lowering medicines in adults with high blood cholesterol levels called primary hyperlipidemia (including a type of high cholesterol called heterozygous familial hypercholesterolemia [HeFH]) to reduce low-density lipoprotein (LDL) or bad cholesterol.

We are disappointed to inform you that CVS Caremark has made a decision to stop covering Repatha^® on its insurance plans starting on July 1, 2020.

What does this mean for me?

If you are covered through a CVS insurance plan, you may be asked by CVS to switch from Repatha^® to another medication. Usually, CVS will send you a letter to notify you.
There are some plans associated with CVS that are still covering Repatha^®, so you may not be affected.
Note that CVS pharmacies still dispense Repatha^®.

What can I do if I am affected and want to stay on Repatha^®?

Ask your doctor or pharmacist if a 90-day supply of Repatha^® is right for you. Your insurance plan may now be allowing longer fills of your medication. Reach out to your pharmacist today to see if your next refill can be for a 90-day supply.
Ask your doctor to submit a formulary exception if you are being asked to switch from Repatha^® and you disagree with the CVS formulary decision. The formulary process below may help you stay on Repatha^®.

Step 1: You can send the CVS Global Formulary Exception Form or State Specific Form to your doctor’s office
(Global) https://www.caremark.com/portal/asset/Global_Prior_Authorization_Form.pdf
(State) https://www.caremark.com/wps/portal/HEALTH_PRO_PRIOR_AUTH_CONTACT_INFO
Step 2: Request your doctor to fill out the formulary exception form stating all relevant clinical rationale and documentation to support use of Repatha^®, i.e. example of rationale could be that you are stable and/or responding well to current therapy, or tried and failed or can’t tolerate statins, Praluent^® or other lipid-lowering therapies.

We are here to support you. Please contact us at 1-844-REPATHA if you have any questions.

Important Safety Information

Do not use Repatha^® if you are allergic to evolocumab or to any of the ingredients in Repatha^®.

Before you start using Repatha^®, tell your healthcare provider about all your medical conditions, including if you are allergic to rubber or latex, are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed. The needle covers on the single-dose prefilled syringes and the inside of the needle caps on the single-dose prefilled SureClick^® autoinjectors contain dry natural rubber. The single-dose Pushtronex^® system (on-body infusor with prefilled cartridge) is not made with natural rubber latex.

Tell your healthcare provider or pharmacist about any prescription and over-the-counter medicines, vitamins, or herbal supplements you take.

What are the possible side effects of Repatha^®?

Repatha^® can cause serious side effects including, serious allergic reactions. Stop taking Repatha^® and call your healthcare provider or seek emergency help right away if you have any of these symptoms: trouble breathing or swallowing, raised bumps (hives), rash or itching, swelling of the face, lips, tongue, throat or arms.

The most common side effects of Repatha^® include: runny nose, sore throat, symptoms of the common cold, flu or flu-like symptoms, back pain, high blood sugar levels (diabetes), and redness, pain, or bruising at the injection site.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of Repatha^®. Ask your healthcare provider or pharmacist for more information. Call your healthcare provider for medical advice about side effects.

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Important Safety Information

Important Safety Information