CVS Health Corp, the second-largest manager of drug benefit plans for U.S. employers and insurers, on Monday asked the heart specialists to revamp the guidelines set for treatment of patients with high cholesterol. The move came after the launch of new expensive medications.

The pharmacy benefit manager took the stand in the light of increasing costs for expensive medicationand how they determine the access of LDL cholesterol patients to costly drugs. It argued that it’s an aggressive technique that is used by insurers to obtain high discounts from pharmaceutical companies.

CVS in a letter published in the journal of the American Medical Association stressed on the point that the present methods used to determine cardiovascular risks instead of basic targets for LDL or bad levels do not clearly mention how to choose the most effective and affordable therapy for treating patients.

CVS said it has now become even more necessary after the FDA has approved Praluent, a powerful drug made by Regeneron Pharmaceuticals and Sanofi SA to block PCSK9, a protein that assists LDL cholesterol to remain in the blood.

Some other pharmacy benefit managers along with CVS are worried that the cost of PCSK9s is very high when placed side by side with statins which had been used to fight bad cholesterols for years, and obtainable for less than $50 per month.

As per experts, taking Praluent and Repatha with statins is far more effective at lowering cholesterol by up to 60% compared to using statins alone.

Dr. William Shrank, chief scientific officer at CVS, said, “The current cholesterol management guidelines do not provide clarity as to how these expensive new medications could fit in the treatment paradigm, potentially resulting in some scenarios where a prescriber could consider a PCSK9 inhibitor for a low-risk patient”.