Is the Price Right for the Newest Cholesterol Drugs?

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Major reductions in the prices of the newest cholesterol-lowering drugs, the PCSK9 inhibitors, make them a more reasonable option for some people at high risk of a heart attack, according to a consensus statement from the National Lipid Association (NLA). The statement was published in the July–August 2019 issue of the Journal of Clinical Lipidology.

When the non-statin PCSK9 inhibitors first became available in 2015, the cost was about $14,000 per year—which strictly limited their use. There was uncertainty about whether the benefits of these drugs were worth the large price tag for most patients, and insurers balked at paying.

Since then, the makers of the two available PCSK9 inhibitors, evolocumab (Repatha) and alirocumab (Praluent), have lowered their prices by 60 percent— to just under $5,900 a year. The NLA says the price reductions have made the drugs cost-effective for certain patients at high to extremely high risk. That includes people with at least a 20 percent risk of having a heart attack in the next 10 years, plus those with LDL levels that are higher than desired (greater than 100 mg/dL) despite standard treatment with a high-dose statin and ezetimibe (Zetia).

Affordability is another matter. When Repatha maker Amgen announced its price cut in 2018, it said Medicare patients’ co-pays should drop to $25 to $150 per month. Check with your plan to verify the cost to you.