A new type of cholesterol-lowering drug called Praluent™ has recently received approval from the Food and Drug Administration (FDA). Praluent is the first of several expected PCSK9 inhibitors that are rapidly making their way through the new drug approval process. These new drugs have been shown to be highly effective at lowering LDL cholesterol, but are also going to be very expensive.
Here are some key concepts:
- PCSK9 inhibitors have a different way of working than existing treatments for high blood cholesterol such as statin drugs like Lipitor® or Crestor®. They are intended to be used in addition to statins in patients with very high LDL cholesterol levels, or to be used in patients who cannot tolerate statins.2
- Unlike existing statins, PCSK9s are specialty, or biologic drugs. Specialty drugs often require special handling or medical supervision when they are used. PCSK9s are administered via self-injection, given either every two weeks or monthly. In contrast, oral statins are taken daily.3
- Another characteristic of specialty drugs is that they are often very expensive. The average cost of a year’s supply of generic statins is less than $200. By contrast, the annual cost of the first PCSK9 inhibitor was set at $14,600 per year.
PCSK9 inhibitors are not intended for the ordinary person with high cholesterol. The vast majority of people should continue to be managed with generic statins – without the addition of a PCSK9 inhibitor.
The FDA approval for Praluent is carefully worded to limit its use to two groups: 1) patients who are diagnosed with a genetic condition leading to high cholesterol, 2) patients who are at high risk and whose cholesterol is uncontrolled on statin therapy.2 Another group, which includes patients who are unable to tolerate statin therapy could possibly also be added once long-term cardiology studies are concluded.
Besides taking this new cholesterol drug or any medication to reduce your cholesterol levels, here are some tips to improve your heart health:
- Limit your intake of foods full of saturated fats, trans fats, and dietary cholesterol. Foods with a lot of saturated fat include butter, fatty flesh like red meat, full-fat and low-fat dairy products, palm oil, and coconut oil. If you see partially hydrogenated fat in the Ingredient List of a food label, that food has trans fats. One type of fat – omega-3 fatty acids – has been shown to protect against heart disease. Good sources are cold-water fish like salmon, mackerel, halibut, trout, herring, and sardines. Limit your intake of meat, poultry, and fish to no more than 3.5 to 4 ounces per day.
- Eat a lot more fiber-rich foods (especially soluble fiber from foods like beans, oats, barley, fruits, and vegetables). Foods naturally rich in soluble fiber have proven particularly good at lowering cholesterol. Excellent sources include oats, oat bran, barley, peas, yams, sweet potatoes and other potatoes, as well as legumes or beans, such as pinto beans, black beans, garbanzo beans, and peas. Vegetables rich in soluble fiber include carrots, Brussels sprouts, beets, okra, and eggplant. Good fruit sources are berries, passion fruit, oranges, pears, apricots, nectarines, and apples.
- Choose protein-rich plant foods (such as legumes or beans, nuts, and seeds) over meat. Common legumes include lentils, peas, and beans, such as pinto beans, red beans, white beans, and soybeans. They’re full of nutritional riches and are a very healthy, protein-packed alternative to meat. Legumes help lower total cholesterol, LDL cholesterol, blood sugar, and insulin levels, and may even lower cancer risk. Nuts and seeds have been proven to modestly lower LDL cholesterol levels. To avoid blood-pressure-raising salt, choose raw or dry-roasted, unsalted varieties.
- Lose as much excess weight as possible. Losing excess weight is beneficial for all sorts of reasons, from improving your cholesterol profile to preventing diseases epidemic in industrialized societies, including type 2 diabetes, high blood pressure, heart attacks, strokes, gout, and many types of cancer.
If you need more information on the medications covered by your health plan, contact us and we will help you.