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Editorials |19 February 2019

A Pound of Prevention? Assessing the Value of New Cholesterol-Lowering Drugs

Mark A. Hlatky, MD

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This article was published at Annals.org on 1 January 2019.
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Although cardiovascular disease has been decreasing for decades, it remains the leading cause of death in the United States. Further progress will require both optimal application of proven approaches and the development of new ways to prevent and treat atherosclerosis. Inhibitors of proprotein convertase subtilisin/kexin 9 (PCSK9), which substantially reduce cholesterol levels, are an exciting new approach based on insights from genetics and rational drug development (1). However, the U.S. Food and Drug Administration–approved PCSK9 monoclonal antibodies, alirocumab (2) and evolocumab (3), came to market priced at $14 000 per year—more than 100 times the cost of a generic statin. An ounce of prevention might be worth a pound of cure, but how much is a pound of prevention worth?
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Hlatky MA. A Pound of Prevention? Assessing the Value of New Cholesterol-Lowering Drugs. Ann Intern Med. ;170:264–265. doi: 10.7326/M18-3632

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Published: Ann Intern Med. 2019;170(4):264-265.

DOI: 10.7326/M18-3632

Published at www.annals.org on 1 January 2019

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2019 American College of Physicians
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