After the introductions of sofosbuvir (Sovaldi) and ledipasvir plus sofosbuvir 
(Harvoni) for the treatment of hepatitis C, employers have become very sensitive 
to new, and especially unforeseen, factors that significantly raise healthcare 
costs. With the recent launch of the proprotein convertase subtilisin/kexin type 
9 (PCSK9) inhibitors, self-insured and fully insured employers have been seeking 
information on this drug class and its potential for off-label use, which could 
amount to up to $23 billion in healthcare expenditures, according to a report 
from Prime Therapeutics. Based on their approved indications, 0.4% of commercial 
members may be eligible to use PCSK9 inhibitors, at a cost of $3.29 per member 
per month. Corporate employers are evaluating their options to manage the new 
expense associated with the novel PCSK9 inhibitors.