PCSK9 inhibition: from effectiveness to cost-effectiveness
Open accessAbstract
Dyslipidaemia is a complex disorder characterised by abnormal lipid levels in the blood, including cholesterol and triglycerides, and plays an important role in the development of atherosclerotic cardiovascular disease. Most risk factors for cardiovascular disease are modifiable, and dyslipidaemia is a key factor among them. It can result from a combination of genetic and environmental factors. A distinction is made between primary dyslipidaemia, which is mainly caused by inherited genetic changes, and secondary dyslipidaemia, which is due to underlying diseases or certain medications. The treatment of dyslipidaemia has evolved over the years. In the past, statins were the first choice, but newer drugs, such as proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, have gained prominence due to their effectiveness in lowering lipids. Although recent guidelines recommend PCSK9 inhibitors for high-risk patients and patients who cannot tolerate statins, their widespread use is limited because of cost. Several meta-analyses have confirmed the efficacy and safety of PCSK9 inhibitors and have shown a significant reduction in low-density lipoprotein (LDL) cholesterol levels. However, the long-term side effects and interactions with other risk factors for cardiovascular disease remain uncertain. In addition, cost-effectiveness analyses have shown mixed results, with some countries considering PCSK9 inhibitors to be cost-effective for certain patient groups, while others consider them less economical. Meanwhile, initial data from patients using PCSK9 inhibitors support the results of the clinical trials. To summarise, PCSK9 inhibitors represent a revolutionary solution for lowering LDL cholesterol, but their cost-effectiveness remains controversial. Despite the controversy, they offer clear benefits for high-risk patients and should therefore be considered in the treatment of dyslipidaemia.
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Non-statin alternative medications such as PCSK9 inhibitors have substantial costs.
“Meanwhile, the non-statin alternative medications such as PCSK9 inhibitors suffer from substantial costs [7]”
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The effect of PCSK9 inhibitors on cardiovascular outcomes in diabetic patients: a narrative review
Sharafeldin, A.-B. K., Aljundi, N. E. T., Hussain, A., AlAraibi, A. J., & Butler, A. E. (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.1853705
Chowdhury, D., Rao, M. M., Sahu, R., Choubey, P. K., Namdeo, K. P., & Bodakhe, S. H. (2026) · The American Journal of the Medical Sciences · doi:10.1016/j.amjms.2026.10.012
- Authors
- Mercep, I., Strikic, D., Hrabac, P., Pecin, I., & Reiner, Ž.
- Affiliations
- University Hospital Centre Zagreb (HR)
- Venue
- Frontiers in Cardiovascular Medicine
- Publisher
- Frontiers Media SA
- Published
- 2024-06-25
- Volume
- 11
- Pages
- 1339487-1339487
- ISSN
- 2297-055X (ISSN-L)
- PMC
- PMC11234837
- OpenAlex
- W4400014529
- Cited by
- 31
- References
- 55
- Citations by year
- 2026: 10 · 2025: 17 · 2024: 4
- FWCI
- 3.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Cardiovascular Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- PCSK9 inhibitors, dyslipidemia, cost-effectiveness, LDL cholesterol lowering, atherosclerotic cardiovascular disease, statins, long-term safety, lipid-lowering therapy
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