Iryo,
good point:
Presumably, step therapy works as follows:
(1) MD to UHC: " My post-MI diabetic patient with 3 stents and CAD/PAD already on generic omega 3 ethyl esters for the last year with TG=135, has had a recent stroke, his LDL is 70 mg/dl on max tolerated statin. Can my patient have Vascepa please for CV risk reduction?"
(2) UHC to MD: "No we don't believe in CV risk reduction or EPA after Dr Nissen's STRENGTH trial, Come back when TG is >150" then you can try a fibrate or if we have some generic icosapent ethyl in at a good PBM price we might let you have some...BTW who is this Dr Bhatt you keep quoting?
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