Statins Versus PCSK9 Inhibitors: Which is More Beneficial?

Article

New research explores the difference between statins and PCSK9 inhibitors.

High levels of low-density lipoprotein (LDL) can increase the risk of heart disease and stroke. Approximately 70 million Americans have elevated levels of this cholesterol, and only 1 in 3 have their condition under control.

Some patients with high levels of LDL cholesterol can improve the condition through diet and exercise. Those who cannot must seek medication-assisted treatments to prevent adverse health effects.

As a part of their commitment to healthcare transparency, the Alliance of Community Health Plans launched an infographic series called “Spike in Drug Costs.” The most recent installment focuses on cholesterol medications, statins, and PCSK9 inhibitors.

The first-line of treatment for high LDL cholesterol is statins, which are typically well-tolerated and safe. However, approximately 15% of patients experience statin intolerance, but healthcare providers are able to successfully manage more than 90% of statin-intolerant patients, according to the infographic.

Another benefit of statins is how low-cost they are. For most patients, the drugs can cost as little as $3.30 per month, but this is not the case with newly-developed PCKS9 inhibitors. These drugs are the best treatment option for patients with familial hypercholesterolemia, a genetic disorder characterized by high levels of LDL cholesterol and early onset of heart disease.

However, the effects PCKS9 inhibitors have on cardiovascular morbidity and mortality are currently unknown, according to the Alliance of Community Health Plans. Costing between $1139 and $1176 per month, this new treatment option has the potential to significantly increase healthcare costs.

This is a concern for many Americans, especially those with high deductible health insurance plans. Many pharmaceutical companies have been implementing savings programs, rebates, and other discounts to attempt to offer patients some relief from high out-of-pocket costs for certain drugs.

With medication so costly, it is unlikely that these programs and discounts would provide much relief for patients. Other research revealed that the drugs were estimated to reduce cardiovascular care-related costs by $29 billion from 2015 to 2020.

Despite those savings, they found that drug costs increased by $592 billion, and are projected to increase even further. The annual cost of PCSK9 inhibitors for 1 patient can cost up to $14,308, while statins can cost as little as $40 per year.

According to the infographic, up to 356 patients can receive generic statins for the amount that it costs to treat 1 patient with a PCSK9 inhibitor. These findings suggest that while PCKS9 inhibitors may be beneficial for some patients, a large majority will benefit from statins as the first-line treatment.

These guidelines may help combat rising drug costs as well.

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Aimee Keegan, PharmD, BCOP, a clinical pharmacist
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