Kevin Alexander, MD, FACC, FHFSA

How payers curb inappropriate ATTR-CM therapy use with better scans, prior auth, real-world outcomes, and telemedicine to speed access.

Experts weigh prior authorization, step therapy, and 12‑month coverage to balance access and cost for high‑value long‑term therapies.

Real-world evidence and claims data compare amyloidosis therapies, linking outcomes and symptom burden to total cost of care.

In this episode, ‘Assessing Clinical and Economic Factors in Treatment Selection and Payer Decision-Making,’ the panelists explore the key clinical and economic considerations that drive therapy selection across the three available ATTR-CM treatments. Dr. Alexander opens by emphasizing shared decision-making as a foundational principle, noting that in the absence of head-to-head data, patient preferences carry significant weight alongside clinical judgment. He outlines several practical factors influencing treatment choice, including route of administration, as vutrisiran is a quarterly injection given in a healthcare setting, acoramidis is a twice-daily oral pill, and tafamidis is a once-daily oral pill, each presenting distinct advantages depending on patient circumstances such as pill burden or transportation access.

Long-term ATTR-CM trial data show durable benefits with early tafamidis or acoramidis, fewer deaths/hospitalizations, and manageable safety.

Learn how TTR stabilizers and gene silencers curb amyloid buildup in ATTR-CM, with trial evidence for fewer hospitalizations and better survival.