Adding a New Pill Lowers Cholesterol and Saves Money in Spain

In Spain, many adults with high or very high heart risk still have LDL cholesterol above target. They already take statins, and some also take ezetimibe. Despite that, only a small fraction reaches the desired level. Stronger options like PCSK9 inhibitors or inclisiran exist, but their price keeps them out of reach for most.

Researchers ran a computer simulation using data from almost 35,000 Spanish patients. They tested what happens if bempedoic acid is added before moving to the expensive injectables. After accounting for ezetimibe alone, about 17 percent of patients hit the LDL goal. Adding bempedoic acid pushed another 32 percent into the target range. When the simulation then allowed a switch to PCSK9i or inclisiran, control rose further – up to 49 percent more with the inhibitor and 39 percent more with inclisiran.

If doctors went straight to the injectables, the same overall control appeared (about 98 percent with PCSK9i and 88 percent with inclisiran) but the yearly cost was much higher. Inserting bempedoic acid first cut the yearly expense by roughly 30 percent for both paths. This shows that using the new pill early can keep cholesterol in check while sparing the budget.

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