Repatha on PBS for FH

Amgen announces that the PBS listing of Repatha (evolocumab) will be expanded to include the treatment of heterozygous familial hypercholesterolaemia (HeFH) in those with “bad cholesterol” (LDL-C) greater than 5mmol/l, and the treatment of HeFH in those who have symptomatic clinical atherosclerotic cardiovascular disease (ASCVD) in those with “bad cholesterol” (LDL-C) greater than 3.3mmol/l1 .

A third of high-risk patients struggle to reach recommended LDL-C targets on current treatments,2 with those living with a genetically inherited risk of high cholesterol at greatest risk of a cardiovascular (CV) event3.

From November 1, 2018, some of the 77,000 people living with HeFH, or HeFH with ASCVD, may now benefit from access to Repatha on the PBS1,4.

FH is an inherited condition that causes people to have elevated “bad cholesterol” – known as LDL-C – despite a person’s age, physical activity and diet4,6. If left untreated, 90 per cent of people with FH are at high risk of experiencing a CV event and may experience as many as four times more CV events in their lifetime5. Symptomatic ASCVD includes heart attack, stroke and peripheral artery disease1.

The Royal Perth Hospital’s Professor Gerald F Watts says FH is the single most common genetic and treatable cause of early heart disease that should be detected in childhood and managed with evidence-based treatments throughout a patient’s life.

“As many as one in 250 Australians suffer from FH, but most remain unrecognised and untreated,” Professor Watts said. “Screening for FH from an early age, especially for those with a family history of high cholesterol and premature heart disease, and providing guidance on evidence-based lifestyle changes and cholesterol lowering treatments, will help to prevent the development of coronary heart disease in vulnerable patients.”

Despite being at high-risk, 90 per cent of adults and 98 per cent of children with FH remain undiagnosed3. If patients are struggling to manage their cholesterol, or if high cholesterol runs in their family, it is recommended they talk to their doctor about the treatment options available to them. FH can be identified by a patient’s doctor through a clinical assessment or a genetic test7.

“Because FH is due to a major genetic defect, most patients with FH are unable to lower their cholesterol to the necessary levels to prevent heart disease with usual treatments,” Professor Watts said. “While a healthy lifestyle and statins and ezetimibe can be effective, many FH patients require additional cholesterol-lowering pharmacotherapies to close the gap in treatment.”

For more information, visit:


  1. Australian Department of Health. Schedule of Pharmaceutical Benefits. Summary of changes, effective 1 November 2018.
  2. Waters D, Brontons C, Chiang C-W, et al. Lipid treatment assessment project 2: a multinational survey to evaluate the proportion of patients achieving low-density lipoprotein cholesterol goals. Circulation 2009; 120:28-34.
  3. FH Australasia Network. Familial Hypercholesterolaemia Fact Sheet. Available at:
  4. FH Australasia Network. What is FH? Available at:
  5. Villa et al. Prediction of cardiovascular risk in patients with familial hypercholesterolaemia. European Heart Journal – Quality Care and Clinical Outcomes 2017; 0:1-7.
  6. Preventive Cardiovascular Nurses Association. FH Fact sheet. Available at:
  7. Watts, GF & Bell D, Progress in the care of familial hypercholesterolaemia: 2016. Medical Journal of Australia 2016; 205 (5): 232-236.
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