CVS Health Corp., which is the second largest manager of drug benefit plans in the United States, has asked heart specialists to change the their guidelines for treating people who have high cholesterol — a move made in light of some extremely expensive medications that are about to hit the market.

The battle over U.S. healthcare costs has been increasing, as insurers look to get big discounts from drugmakers, and drugmakers introduce more and more expensive drugs in hopes of maximizing their profits, according to a Reuters report.

CVS published a letter in the Journal of the American Medical Association arguing that the current guidelines don’t provide much guidance on the best and most cost-effective therapy to fight against “bad” LDL cholesterol. CVS pointed to the U.S. Food and Drug Administration’s recent approval of Praluent, a potent but expensive new drug that would block a protein called PCSK9 which helps LDL stay in the bloodstream. CVS is concerned that the cost of PCSK9 blockers is extreme, at about $15,000 per year, compared to just $50 per month for traditional cholesterol fighters like statins. When combined with statins, Praluent and another drug, Repatha, show a lower cholesterol rate of 60 percent compared with just statins alone.

The problem with current guidelines are not clear — even though these drugs are effective, they may not be necessary for a patient at low risk. Without guidelines, doctors may needless prescribe a hugely expensive drug for someone who doesn’t need it and for whom statins alone is just fine.

About 73 million Americans are believed to suffer from higher cholesterol than healthy. The AHA said only that it would continually weigh recommendations against current science when it comes to new guidelines.