| Homozygous Familial Hypercholesterolemia
Juxtapid vs Repatha
Side-by-side clinical, coverage, and cost comparison for homozygous familial hypercholesterolemia.Deep comparison between: Juxtapid 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 Juxtapid based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Repatha but not Juxtapid, including UnitedHealthcare
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Category
Juxtapid
Repatha
At A Glance
Oral
Daily
MTP inhibitor
SC injection
Every 2 weeks or monthly
PCSK9 inhibitor
Indications
- Homozygous Familial Hypercholesterolemia
- Hypercholesterolemia
- Familial hypercholesterolemia - heterozygous
- Homozygous Familial Hypercholesterolemia
Dosing
Homozygous Familial Hypercholesterolemia Initiate at 5 mg once daily with water, without food, at least 2 hours after the evening meal; titrate to 10 mg after at least 2 weeks, then at minimum 4-week intervals to 20 mg, 40 mg, and up to 60 mg daily maximum; patients with ESRD on dialysis or mild hepatic impairment (Child-Pugh A) should not exceed 40 mg daily.
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
- Pregnancy
- Concomitant use of moderate or strong CYP3A4 inhibitors
- Moderate or severe hepatic impairment (Child-Pugh B or C) or active liver disease, including unexplained persistent elevations of serum transaminases
- History of serious hypersensitivity reaction to evolocumab or any excipient in REPATHA
Adverse Reactions
Most common (>=28%) Diarrhea, nausea, vomiting, dyspepsia, abdominal pain
Serious Hepatotoxicity, increased ALT
Postmarketing Myalgia, alopecia
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
MTP inhibitor; lomitapide directly binds and inhibits microsomal triglyceride transfer protein (MTP) in the endoplasmic reticulum, preventing assembly of apo B-containing lipoproteins in enterocytes and hepatocytes, thereby inhibiting synthesis of chylomicrons and VLDL and reducing plasma LDL-C.
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
Juxtapid
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
Repatha
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (10/12) · Qty limit (11/12)
UnitedHealthcare
Juxtapid
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (5/8) · Qty limit (0/8)
Repatha
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (3/8) · Qty limit (7/8)
Humana
Juxtapid
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · 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
Cost estimate not availableHealthWell: Hypercholesterolemia - Medicare Access
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAmgen Safety Net Foundation: Repatha
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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JuxtapidView full Juxtapid profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.