| Homozygous Familial Hypercholesterolemia
Lipitor vs Repatha
Side-by-side clinical, coverage, and cost comparison for homozygous familial hypercholesterolemia.Deep comparison between: Lipitor 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 Lipitor based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Repatha but not Lipitor, including UnitedHealthcare
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Category
Lipitor
Repatha
At A Glance
Oral
Daily
HMG-CoA reductase inhibitor (statin)
SC injection
Every 2 weeks or monthly
PCSK9 inhibitor
Indications
- Myocardial Infarction
- Cerebrovascular accident
- Stable angina
- Diabetes Mellitus, Non-Insulin-Dependent
- Congestive heart failure
- Hyperlipidemia
- Familial hypercholesterolemia - heterozygous
- Homozygous Familial Hypercholesterolemia
- Hyperlipoproteinemia Type III
- Hypertriglyceridemia
- Hypercholesterolemia
- Familial hypercholesterolemia - heterozygous
- Homozygous Familial Hypercholesterolemia
Dosing
Myocardial Infarction, Cerebrovascular accident, Stable angina, Diabetes Mellitus Non-Insulin-Dependent, Congestive heart failure, Hyperlipidemia, Hyperlipoproteinemia Type III, Hypertriglyceridemia 10 or 20 mg once daily starting; range 10-80 mg once daily; patients requiring LDL-C reduction >45% may start at 40 mg once daily; oral.
Familial hypercholesterolemia - heterozygous Adults: 10 or 20 mg once daily, range 10-80 mg once daily; pediatric patients aged >=10 years: 10 mg once daily starting, range 10-20 mg once daily; oral.
Homozygous Familial Hypercholesterolemia Adults: 10 or 20 mg once daily, range 10-80 mg once daily; pediatric patients aged >=10 years: 10-20 mg once daily starting, range 10-80 mg once daily; oral.
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
- Acute liver failure or decompensated cirrhosis
- Hypersensitivity to atorvastatin or any excipient in Lipitor
- History of serious hypersensitivity reaction to evolocumab or any excipient in REPATHA
Adverse Reactions
Most common (>=2%) Nasopharyngitis, arthralgia, diarrhea, pain in extremity, urinary tract infection, dyspepsia, nausea, musculoskeletal pain, muscle spasms, myalgia, insomnia, pharyngolaryngeal pain
Serious Myopathy and rhabdomyolysis, immune-mediated necrotizing myopathy, hepatic dysfunction, increases in HbA1c and fasting serum glucose
Postmarketing Pancreatitis, fatigue, fatal and non-fatal hepatic failure, anaphylaxis, tendon rupture, rhabdomyolysis, myositis, dizziness, peripheral neuropathy, cognitive impairment, myasthenia gravis exacerbation, depression, interstitial lung disease, angioneurotic edema, bullous rashes
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
Lipitor is a selective, competitive inhibitor of HMG-CoA reductase, the rate-limiting enzyme that converts 3-hydroxy-3-methylglutaryl-coenzyme A to mevalonate, a precursor of cholesterol; it lowers plasma LDL cholesterol and lipoprotein levels by inhibiting hepatic cholesterol synthesis and upregulating LDL receptor expression on hepatic cell surfaces.
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
Lipitor
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (5/12) · Qty limit (1/12)
Repatha
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (10/12) · Qty limit (11/12)
UnitedHealthcare
Lipitor
- 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
Lipitor
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (1/3)
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 Lipitor.
Cost estimate not availableAmgen Safety Net Foundation: Repatha
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.