Consumption and expenditure of drugs used for the treatment of hypercholesterolemia: a governance analysis

Abstract

Background: Elevated cholesterol levels are a significant contributor to cardiovascular disease risk. While statins have long been the cornerstone for lowering LDL cholesterol, their associated side effects have prompted the exploration of alternative treatments, including ezetimibe, bempedoic acid, PCSK9 inhibitors and inclisiran.f.

Research design and methods: This research seeks to analyze the usage patterns and financial implications during 2023 and 2024. The goal is to assess the economic impact of emerging therapies in hypercholesterolemia.

Results: Findings indicate a decline in the exclusive use of traditional statins and a rise in the adoption of newer and combination therapies. Statin monotherapy usage decreased markedly from 42% in 2023 to 30% in 2024. Combination treatments, such as statins paired with ezetimibe, remained steady at 17% across both time frames. The utilization of novel treatments, notably PCSK9 inhibitors, increased from 33% to 40% between the two periods, whereas bempedoic acid, whether used alone or with ezetimibe, stayed below 2%.

Conclusion: The landscape of hypercholesterolemia treatment has expanded with several new therapeutic options. Bempedoic acid may mitigate adverse effects and enhance treatment efficacy, potentially delaying the need for costlier injectable medications like evolocumab, alirocumab, and inclisiran.

Keywords: Cholesterol; PCSK9; hypercholesterolemia; siRNA; statins.