| Familial hypercholesterolemia - heterozygous
Repatha vs Welchol
Side-by-side clinical, coverage, and cost comparison for familial hypercholesterolemia - heterozygous.Deep comparison between: Repatha vs Welchol with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsWelchol has a higher rate of injection site reactions vs Repatha based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Welchol but not Repatha, including UnitedHealthcare
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Category
Repatha
Welchol
At A Glance
SC injection
Every 2 weeks or monthly
PCSK9 inhibitor
Oral
Daily
Bile acid sequestrant
Indications
- Hypercholesterolemia
- Familial hypercholesterolemia - heterozygous
- Homozygous Familial Hypercholesterolemia
- Familial hyperlipidemia
- Familial hypercholesterolemia - heterozygous
- Diabetes Mellitus, Non-Insulin-Dependent
Dosing
Hypercholesterolemia, Familial hypercholesterolemia - heterozygous 140 mg every 2 weeks or 420 mg once monthly administered subcutaneously.
Homozygous Familial Hypercholesterolemia 420 mg once monthly subcutaneously; may increase to 420 mg every 2 weeks if a clinically meaningful response is not achieved in 12 weeks.
Familial hyperlipidemia, Familial hypercholesterolemia - heterozygous 3.75 grams daily; 6 tablets once daily or 3 tablets twice daily with a meal and liquid, or one packet oral suspension once daily with a meal.
Diabetes Mellitus, Non-Insulin-Dependent 3.75 grams daily; 6 tablets once daily or 3 tablets twice daily with a meal and liquid, or one packet oral suspension once daily with a meal.
Contraindications
- History of serious hypersensitivity reaction to evolocumab or any excipient in REPATHA
- Serum TG concentrations >500 mg/dL
- History of hypertriglyceridemia-induced pancreatitis
- History of bowel obstruction
Adverse Reactions
Most common (>=3%) Nasopharyngitis, upper respiratory tract infection, influenza, back pain, injection site reactions, cough, urinary tract infection, sinusitis, headache, myalgia, dizziness, musculoskeletal pain, hypertension, diarrhea, gastroenteritis
Serious Hypersensitivity reactions including angioedema
Postmarketing Angioedema, influenza-like illness
Most common (>=2%) Constipation, dyspepsia, nausea, asthenia, pharyngitis, myalgia (primary hyperlipidemia); constipation, dyspepsia, nausea, hypertension, back pain (type 2 diabetes)
Serious Hypertriglyceridemia, pancreatitis, gastrointestinal obstruction, vitamin K and fat-soluble vitamin deficiencies
Postmarketing Bowel obstruction, dysphagia, esophageal obstruction, fecal impaction, pancreatitis, hypertriglyceridemia, increased transaminases
Pharmacology
Evolocumab is a human monoclonal IgG2 antibody that inhibits PCSK9, thereby increasing LDL receptor availability on hepatocytes and lowering LDL-C levels.
Colesevelam hydrochloride is a non-absorbed bile acid sequestrant that binds bile acids in the intestine, depletes the bile acid pool, upregulates hepatic cholesterol 7-alpha-hydroxylase, increases LDL receptor expression, and thereby lowers serum LDL-C; the mechanism by which it improves glycemic control in type 2 diabetes is unknown.
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Most Common Insurance
Anthem BCBS
Repatha
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (10/12) · Qty limit (11/12)
Welchol
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Repatha
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (3/8) · Qty limit (7/8)
Welchol
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Repatha
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Welchol
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAmgen Safety Net Foundation: Repatha
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Welchol.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.