JAMA Report On Cholesterol Drugs Fails Reliability Test

To The Editor:

The August 17 article “Another analysis finds new cholesterol drugs are not cost-effective” highlights a cost-effectiveness model published in JAMA that threatens to make it even more difficult for patients with high cholesterol to access new medicines called PCSK9 inhibitors.   

Statins work extremely well for most patients with high cholesterol.  Currently, PCSK9 inhibitors are intended for high-risk patients who have already had a cardiovascular event and those with genetic pre-dispositions to very high cholesterol who are already on an optimal statin dose and cannot reach their desired LDL goals.

Cardiovascular disease (CVD) takes an American life every 40 seconds and costs the U.S. $600 billion. Driving down the cost of CVD complications is imperative and innovative therapeutics like PCSK9 inhibitors are our best hope.  Unfortunately, nearly a year after the FDA approved these medicines, approximately two-thirds of patients prescribed a PCSK9 inhibitor continue to struggle to get these medicines from their insurer.

The study asserts that these drugs would add $120 billion to U.S. health care spending, but arrived at this conclusion by exaggerating the number of patients who would actually use the drugs and underestimating their risk.  In addition, the authors used the list prices for these medications – rather than the net price payers actually pay for them – to arrive at an inflated cost estimate. 

As new drug treatments are made available, a balanced discussion about value is critical to inform complex decisions – as long as they are based on realistic assumptions. Health experts must focus on collaborating to both assess and unlock the value of innovation, while ensuring patients get access to the medicines they need.


Raymond C. Jordan
Senior Vice President, Corporate Affairs