CVS Health Corp, American healthcare company on Monday, asked heart specialists to revamp the guideline that has been set for treating patients with high cholesterol after the launch of new and expensive medications.

It is said that CVS’s latest move is the salvo in the war on rising US healthcare coats, with insurers using aggressive tactics to extract steep price discounts from drugmakers, even for the newest medications, and controlling patient access to the most expensive drugs.

The pharmacy benefit manager CVS in a letter published in the latest edition of the Journal of the American Medical Association said the current guidelines which include formula for assessing heart disease risk rather than specific targets for levels of LDL cholesterol, do not actually provide clear guidance on how to choose the best, and most cost effective, therapy.

CVS stated the U.S. Food and Drug Administration has approved Praluent, a new drug that works by blocking a protein called PCSK9 that helps LDL cholesterol stay in the bloodstream.

But CVS and other pharmacy benefit managers are concerned about the cost of the PCSK9s compared with older cholesterol fighters such as statins.

Statins is available as generics for less than $50 a month. Praluent, given by injection, has a list price of almost $15,000 a year.

It has been said that both Praluent and Repatha, in combination with statins, have been shown to lower cholesterol by around 60 % as compared to 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”.