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Cholesterol Management in the Era of PCSK9 Inhibitors

  • Public Health Policy (E Klodas, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Cholesterol management in the current era is discussed. Aggressive reduction of low density lipoprotein (LDL) cholesterol plays a key role in primary and secondary prevention of heart disease. Statins are the recommended first-line therapy in patients with hyperlipidemia; however, additional complementary approaches are frequently needed for patients who fail to reach their target LDL.

Recent Findings

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are novel drugs that provide dramatic lowering of LDL and promise outcome benefit. Despite great enthusiasm about their cardiovascular benefit, concerns have been raised regarding their cost and added value to the healthcare system. Although cost-effectiveness studies have yielded inconclusive results, analyses suggest that the current cost of PCSK9 inhibitors is disproportionately high and must be significantly reduced to add positive net benefit to healthcare system.

Summary

PCSK9 inhibitors significantly lower LDL cholesterol. Further outcome data and cost-effectiveness analyses are needed to overcome the current barriers with PCSK9 inhibitors that patients, physicians, and payers face.

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Abbreviations

LDL:

Low density lipoprotein

PCSK9:

Proprotein convertase subtilisin/kexin type 9

FH:

Familial hypercholesterolemia

CVD:

Cardiovascular disease

MACE:

Major adverse cardiovascular events

QALY:

Quality-adjusted life-year

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Anna Svatikova & Stephen L. Kopecky

Authors
  1. Anna Svatikova
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  2. Stephen L. Kopecky
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Corresponding author

Correspondence to Stephen L. Kopecky.

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Conflict of Interest

Anna Svatikova declares that she has no conflict of interest.

Stephen L. Kopecky reports grants from Amgen and True Health, personal fees from Prime Therapeutics, and other from Mayo Clinic P&T task force.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Public Health Policy

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Svatikova, A., Kopecky, S.L. Cholesterol Management in the Era of PCSK9 Inhibitors. Curr Cardiol Rep 19, 83 (2017). https://doi.org/10.1007/s11886-017-0891-5

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  • DOI: https://doi.org/10.1007/s11886-017-0891-5

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