Insurance companies typically require specific criteria, such as familial hypercholesterolemia, a prior cardiac event, or significant statin-induced myopathy, before covering PCSK9 inhibitors.

“so unfortunately most insurance companies will not cover it unless you meet certain criteria such as having familial hyper cholesterolemia or having already had a cardiac event like a heart attack and not being able to tolerate a Statin or what about myopathy like if you have muscle yes significant myopathy on multiple statins but you'd also have to be at high enough risk to justify it so insurance companies are going to go out of their way to not pay for this”