Many friends asked Huazi whether the "lipid-lowering needle" mentioned in the previous science popularization has reduced the price? Huazi said that the "lipid-lowering needle" refers to the PCSK9 inhibitor, which is a class of drugs with strong cholesterol-lowering effects that need to be administered by subcutaneous injection, so it is called "lipid-lowering needles".
Many people cannot reduce low-density lipoprotein cholesterol (LDL-C) to the standard value with statins, even if they add cholesterol absorption inhibitors, and a combination of PCSK9 inhibitors is required for intensive lipid-lowering therapy.
First, what is a PCSK9 inhibitor
Low-density lipoprotein (LDL), which is produced in the human body, can bind to low-density lipoprotein receptors (LDL-R) on liver cells and is then broken down. PCSK9 reduces LDL-R activity on hepatocytes, reducing LDL breakdown, which in turn leads to elevated LDL-C levels.
PCSK9 inhibitors can inhibit PCSK9, thereby enhancing the activity of LDL-R, so that more LDL can bind to LDL-R and hydrolysis, reducing LDL-C levels.
From the data obtained from clinical trials, PCSK9 inhibitors can reduce LDL-C levels by 60% to 70%, and also have a significant reduction effect on lipoprotein (a), and there are few adverse reactions, which is very suitable for lipid-lowering therapy.
Second, what does the drug mean when it enters medical insurance
However, most people are not familiar with PCSK9 inhibitors, and their clinical applications are less common, mainly because of their high price. The monthly treatment cost is as high as 3 to 4,000 yuan, which is not in line with the national conditions of our country and cannot be promoted in a large area.
However, in December 2021, PCSK9 inhibitors entered the national medical insurance directory, and after centralized procurement, the price of drugs fell by more than 70%. The "sky-high drug" that ordinary people could not afford to climb is now affordable.
Each drug that enters the medical insurance is basically a drug that is in great demand by patients and has great benefits to the overall health of the people. PCSK9's entry into medical insurance also shows from the side that the state believes that it is important to strengthen the control of blood lipids and can greatly improve the health level of the people.
PCSK9 inhibitors are not a substitute for statins
Someone has asked Huazi, if you use a "lipid-lowering needle", can you replace statins? Hanako replied that there was no substitute. Statins are traditional cholesterol-lowering drugs, but in addition to controlling cholesterol, statins also have the effect of improving arterial endometrial metabolism, anti-inflammatory, antioxidant, increasing plaque stability, and preventing plaque rupture.
Long-term use of statins can produce the effect of reversing plaque. ALTHOUGH PCSK9 inhibitors reduce cholesterol by a large margin, they are not yet a substitute for statins to reverse the effects of plaque. So PCSK9 inhibitors are now only used for complementary therapy when statins don't work well. May be used in combination with statins, but is not recommended alone.
Fourth, the "three steps" to control high cholesterol
People who find elevated LDL-C levels are usually divided into "three steps" when it comes to lipid-lowering therapy.
The first step, the use of statins for treatment, can reduce LDL-C levels by 40% to 50%. Those with "three high" chronic diseases should control the LDL-C level below 2.6mmol/L; those with cerebral infarction, myocardial infarction, and coronary heart disease should control the LDL-C level below 1.8mmol/L; and in critically ill patients, the LDL-C level should be controlled below 1.4mmol/L.
Second, if the effect of statins alone is not good, in order to reduce the probability of adverse reactions, it is not recommended to use large doses of statins, but to use low and medium doses of statins, plus cholesterol absorption inhibitors for combination. On the basis of statins, LDL-C levels can be reduced by 20% to 30%.
In the third step, after the simultaneous use of statins and cholesterol absorption inhibitors, if the LDL-C level control is still not up to standard, use statins plus PCSK9 inhibitors for combination, or a combination of the three, on the basis of the original, reduce the LDL-C level by 60% to 70%.
To sum up, the "lipid-lowering needle" PCSK9 inhibitor is a new type of powerful lipid-lowering drug, which greatly reduces the price after entering medical insurance, so that ordinary people can also afford it. It shows that the state believes that strengthening the control of blood lipids can greatly improve the health level of the people. Medication use needs to be carried out under the guidance of a doctor, if you have any doubts about medication, please consult a doctor or pharmacist. I am a pharmacist Huazi, welcome to follow me and share more health knowledge.