Blacks, Hispanics, and Women At Higher Risk of Being Denied Life-Saving Medication

Black, Hispanic, and women patients in Arkansas are more likely to face insurance barriers when trying to access a cholesterol-lowering heart medicine, according to a new report. 

Nearly 1 in every 3 Arkansans has their prescription rejected, which represents a rejection rate of 67% higher than the national average. For women, the rejection rate is 40% higher than the national average and 46% for Black women. Black patients are rejected at a 20% higher rate than white patients. Hispanic patients are denied at a 25% higher rate. 

The findings appear in a new policy brief from the Partnership to Advance Cardiovascular Health (PACH) titled “Rejected: How Life-Saving Heart Medication Eludes Women, Southerners, and People of Color.” 

The report details commercial insurance claims data from 2019-2021 for cholesterol-lowering PCSK9 Inhibitors, an injectable drug designed to lower high LDL cholesterol. The medicine is typically prescribed to patients who cannot get their LDL cholesterol down enough through statins alone. It is the most recommended inhibitor as it is shown to decrease LDL cholesterol by up to 70% and cut the risk of a heart attack by almost one-third. 

“Given that cardiovascular disease is the number one cause of death in Arkansas and 37% of people living in the Natural State have high cholesterol, we must take this issue seriously,” said Arkansas

Cardiologist Nasser Adjei, MD, in a press release. “Our patients need access to medications to prevent serious outcomes including heart attacks, strokes, and death.”

People of color are more likely to suffer from cardiovascular disease. Among Hispanic adults, 52% of males and 43% of females have heart disease. So do nearly 48% of Black women and 44% of Black men. 

In their research, PACH discovered patients have great difficulty getting access to medications like the PCSK9 inhibitors, and providers have to overcome many hurdles to get their patients on them. “And that’s very concerning,” said PACH Executive Director Ryan Gough. 

“You have a situation where the patient population that needs this medication are usually people with a genetic condition called familial hypercholesterolemia, or people with high cholesterol who have had an event, for instance, if they’ve already had a heart attack or stroke. We need to be doing everything we possibly can to get those events down. And so, when patients can’t get these medications, things like the PCSK9 inhibitors, their risk for heart attack and stroke goes up.”

Gough said the goal behind the report is to shed light on the issue and bring providers, insurers, and patients together to find a solution to a severe matter affecting Arkansans. 

“We want to call upon the patients and providers in Arkansas to come together and say, ‘why is this happening? And how can we get past that? How can we work together so that we can make sure that people get access to the therapy that they need so that we can bring down these rates and actually make some progress when it comes to cardiovascular disease?'” said Gough. 

PACH is advocating for a preventive strategy to ensure that people have access to medication that will help lower their heart attack and stroke risk.  

“That’s why we exist, to try to empower patients to advocate for themselves in their own health and then also advocate for other patients. Because if we don’t do this stuff together, we’re not going to make progress when it comes to combating the number one killer of Americans,” said Gough.