| Familial hypercholesterolemia - heterozygous
Welchol vs Repatha
Side-by-side clinical, coverage, and cost comparison for familial hypercholesterolemia - heterozygous.Deep comparison between: Welchol vs Repatha 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 signalsRepatha has a higher rate of injection site reactions vs Welchol based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Repatha but not Welchol, including UnitedHealthcare
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Category
Welchol
Repatha
At A Glance
Oral
Daily
Bile acid sequestrant
SC injection
Every 2 weeks or monthly
PCSK9 inhibitor
Indications
- Familial hyperlipidemia
- Familial hypercholesterolemia - heterozygous
- Diabetes Mellitus, Non-Insulin-Dependent
- Hypercholesterolemia
- Familial hypercholesterolemia - heterozygous
- Homozygous Familial Hypercholesterolemia
Dosing
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.
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.
Contraindications
- Serum TG concentrations >500 mg/dL
- History of hypertriglyceridemia-induced pancreatitis
- History of bowel obstruction
- History of serious hypersensitivity reaction to evolocumab or any excipient in REPATHA
Adverse Reactions
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
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
Pharmacology
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.
Evolocumab is a human monoclonal IgG2 antibody that inhibits PCSK9, thereby increasing LDL receptor availability on hepatocytes and lowering LDL-C levels.
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Most Common Insurance
Anthem BCBS
Welchol
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (9/12)
Repatha
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (10/12) · Qty limit (11/12)
UnitedHealthcare
Welchol
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Repatha
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (3/8) · Qty limit (7/8)
Humana
Welchol
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (2/3)
Repatha
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Welchol.
Cost estimate not availableAmgen Safety Net Foundation: Repatha
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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WelcholView full Welchol profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.