New LDL-Lowering Drugs Priced Far Too High, Report Says

By Kelly Young

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, FASAM

The newly approved LDL-lowering drugs alirocumab and evolocumab might improve clinical outcomes for certain patients, but the price for these drugs should be reduced by 85%, according to a report from the Institute for Clinical and Economic Review, a nonprofit that assesses the value of medical tests, procedures, and systems.

At the current annual price of $14,000, the drugs, known as proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, could avert over 130,000 major adverse cardiovascular events in patients with familial hypercholesterolemia and lead to an incremental cost effectiveness ratio of $681,000 per quality-adjusted life-year (QALY). For secondary prevention of patients with prior cardiovascular disease, the ratio was $557,000/QALY.

In all patient groups, the annual price at which the drug would be cost-effective was much lower than the drugs' current price tag. For instance, at a threshold of $50,000/QALY, the drugs would have to cost $2412 annually.

The group recommends a value-based price benchmark of $2177 for each drug, an 85% discount from the wholesale price.