A recent story in the Wall Street Journal really underscores the need for products (and companies) like Step One Foods. The main point of the article was how difficult it is for patients to gain insurance coverage for PCSK9 inhibitors (drugs like Amgen’s Repatha).
And no wonder it’s hard! These injectable cholesterol lowering drugs may be incredibly effective at improving LDL (bad cholesterol), but they’re also incredibly expensive – to the tune of $14,000 per patient per year.
There’s no question that some individuals absolutely need these drugs. Because they have conditions like Familial Hypercholesterolemia (FH) and LDL’s in the 200 to 300 range. FH affects approximately 1 in 250 individuals, or about 1.3 million Americans. Just like the rest of us, some of these folks either can’t tolerate statins or don’t get their cholesterol low enough despite being on maximum statin doses – making them prefect candidates for these novel medications. However these individuals represent a tiny fraction of the patient population that Amgen is targeting.
Amgen estimates that 11 Million Americans are candidates for their drug. That translates into $154 BILLION dollars flowing to the company – every single year. To treat one risk factor for one disease. To put this in perspective, we’re currently spending about $300 billion per year treating ALL of heart disease (including stents and bypass surgery). You can see why insurers might be balking.
So where are all the other 10 Million Repatha users coming from? They’re the folks without a strong genetic predisposition to high cholesterol who have heart disease but are still not at goal cholesterol levels despite maximum tolerated statin doses.
But for most of these, the major underlying driver of their high cholesterol – diet – has never been adequately addressed.
It appears we have finally reached the height of insanity: Instead of figuring out how to make it easy for people to eat better - so that their cholesterol levels come down naturally - we’re busy fighting with insurers to cover expensive drugs. $14,000 per year buys a lot of food. It actually buys a lot in general. Put ten PCSK9 candidates together and you might be able to afford a personal chef, masseuse and athletic trainer for the group!
1 year of Repatha pays for over 10 years of Step One Foods. And we've shown that we can lower LDL cholesterol an average of 39 points in 30 days. Not because we’re pumping bodies full of drugs – but because we’re improving nutrition. We’re targeting the cause of the problem, not just its symptom.
Step One Foods arose out of the recognition that what we’re doing is not working. And that there’s an obvious solution. Which is why we make improving diet as easy as taking a pill.