A Survey of Noninterventional Cardiologists, Endocrinologists, and Managed Care Organization Pharmacy and Medical Directors
The primary goal of therapy for individuals with dyslipidemia is to improve lipid levels with the overarching aim of preventing cardiovascular (CV) events; abnormal lipid levels are associated with increased risk for atherosclerotic CV disease. Statins are the mainstay of medical treatment for patients with dyslipidemia, and they have been shown to improve CV outcomes. On the other hand, few of the current non-statin lipid-modifying agents have good evidence of such benefits. Two novel cases of lipid-modifying agents with the potential to deliver reductions in CV risk are set to enter the market over the next few years. The proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, including Amgen’s evolocumab (Repatha), Sanofi and Regeneron Pharmaceuticals’ alirocumab (Praluent), and Pfizer’s bococizumab, have demonstrated excellent LDL-C-lowering efficacy, and early post hoc data suggest CV benefits. The cholesteryl ester transfer protein (CETP) inhibitors—Merck’s anacetrapib and Eli Lilly’s evacetrapib (both of which have shown good efficacy in more than one lipid abnormality)—are oral once-daily medications that are expected to be priced much lower than the injectable PCSK9 inhibitors.