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“Obviously, the class is one of the biggest developments in cardiology in the last decade, that will allow us to
treat patients who have been extremely difficult to treat with high levels of LDL cholesterol,” says Steven
Nissen, chairman of cardiology at the Cleveland Clinic. “It’s very promising.”
But it will also be very expensive, say Troy Brennan, the chief medical officer of CVS Caremark, the giant
pharmacy benefits manager.“If these drugs are used as broadly as they could be used, they are going to be by
far the most expensive drug class,” Brennan says.
Praluent, an injection, lowers low-density lipoprotein, the so-called “bad cholesterol”, by as much as 60%, far
more than the statin drugs alone. It is the first drug to work by targeting a protein called PCSK9. Mutations in
the gene that makes it can result in patients having lower cholesterol and a dramatically lower lifetime risk of
heart attacks. A rival medicine from Amgen is also expected to be approved soon. The FDA is
clearing Praluent for patients with heterozygous familial hypercholesterolemia, a genetic condition that causes
high cholesterol, and for people who have heart disease, like those who’ve had heart attacks or strokes, who
are already taking the maximum dose of a statin they can tolerate.
Regeneron and its marketing partner Sanofi say Praluent will have a wholesale cost of $40 a day, or $14,600 a
year, for either of two doses, 75 milligrams or 150 mgs. It’s likely that insurance companies will get a
significant discount, because Amgen and Regeneron will compete by giving the insurers rebates.
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