Step Therapy Praluent
Defines UnitedHealthcare step therapy requirements for coverage of Praluent (alirocumab) for hyperlipidemia (primary hyperlipidemia, HeFH, ASCVD) and homozygous familial hypercholesterolemia (HoFH), including required prior trial(s) of statin therapy and Repatha (evolocumab), authorization duration, and additional clinical rules.
Added Repatha (evolocumab) as required step prior to Praluent in many pathways (added 6/2021).
Added criterion for patients less than 10 years of age to align with new pediatric label (May 2024).
Clarified criterion for contraindication to statins (May 2025) without change to clinical intent.
Effective Date set to 8/1/2025 per header.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.