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Research Letter
August 22/29, 2017

Updated Cost-effectiveness Analysis of PCSK9 Inhibitors Based on the Results of the FOURIER Trial

Author Affiliations
  • 1Division of Cardiology, Zuckerberg San Francisco General Hospital, San Francisco, California
  • 2Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California
  • 3Division of General Internal Medicine, Columbia University Medical Center, New York, New York
  • 4Institute for Clinical and Economic Review, Boston, Massachusetts
  • 5Department of Medicine, University of California, San Francisco
JAMA. 2017;318(8):748-750. doi:10.1001/jama.2017.9924

A cost-effectiveness analysis of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors based on their lowering of low-density lipoprotein cholesterol (LDL-C) demonstrated that the 2015 price of PCSK9 inhibitors would need to be reduced by more than two-thirds (to $4536 per year) to meet generally accepted cost-effectiveness thresholds.1 Since that report, the Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk (FOURIER) trial found the PCSK9 inhibitor evolocumab reduced risk of major adverse cardiovascular events (MACE; myocardial infarction, stroke, or cardiovascular death).2 This study assessed how the cost-effectiveness of PCSK9 inhibitors is altered by the FOURIER results and current prices.