New cholesterol drugs good for patients, may drive up costs

Researchers say PCSK9 inhibitors could reduce heart attacks, strokes and death but may be "cost-prohibitive" for widespread use in the United States.

By Stephen Feller

SAN FRANCISCO, Aug. 17 (UPI) -- Although a new class of cholesterol drugs is expected to help reduce heart attacks, strokes and death from other cardiovascular conditions, their high cost may prevent widespread adoption in the United States.

PCSK9 inhibitors have been heralded as a dramatic improvement over current standard treatments for high cholesterol, but researchers at the University of California San Francisco predict they would be "cost-prohibitive" -- prescribing them to all eligible adults would increase health care spending by 38 percent, an unspeakable amount for treating a single condition.


The drugs alirocumab and evolocumab, both PCSK9 inhibitors, were approved by the FDA last year for use with a genetic, hard-to-treat form of high cholesterol and specific types of heart disease.

UCSF researchers point out, however, that the drugs have the potential to help more than than the small group of patients for whom the FDA initially approved them.

Considering treatment for high cholesterol is a lifelong therapy, the researchers compared how much the new drugs cost per year per patient with the cost of another cholesterol drug, ezetimibe, which is used with patients for whom statins have not worked.


While the drugs can decrease cholesterol levels by about 20 percent more than statins, the researchers say the increase to prescription drug costs would be significant.

"If all eligible US adults were put on PCSK9 inhibitors we'd face an unsustainable increase in healthcare spending," Dr. Dhruv Kazi, an assistant professor of medicine at the University of California San Francisco, said in a press release.

For the study, published in the Journal of the American Medical Association, researchers compared the estimated $14,350 annual cost of PCSK9 inhibitor treatment to the cost of standard care using the Cardiovascular Disease Policy Model.

The cost of cardiovascular care for all eligible patients would drop by about $29 billion over five years, the researchers say, but prescription drug costs would increase by $592 billion and would add $120 billion to overall annual healthcare expenditures in the United States.

In order for the the drugs to be cost-effective, PCSK9 drugs would have to drop to about $4,536 per patient per year, a nearly $10,000 decrease from their current price point.

And though the new drugs are far more effective, or at least have been in trials so far, the researchers also note that fully treating all people with statins who can benefit but do not use them yet would save about $12 billion in healthcare costs over five years.


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