Evinacumab (Evkeeza)
Evinacumab (Evkeeza) is an intravenous ANGPTL3 antibody for homozygous familial hypercholesterolemia (HoFH). It lowered LDL cholesterol by 49% versus placebo at 24 weeks on top of background therapy. Study results
How much does evinacumab lower LDL cholesterol?
Evinacumab 15 mg/kg every four weeks lowered LDL cholesterol by 49% versus placebo at week 24 in patients with HoFH receiving other lipid-lowering treatments. Read the evidence.
| Dose and treatment context | LDL result |
|---|---|
| 15 mg/kg IV every four weeks | 49% vs. placebo |
This result applies to HoFH, a rare inherited condition. Evkeeza is not a routine alternative for common high cholesterol.
Individual responses vary. LDL and ApoB measure different things; these LDL percentages should not be used as ApoB estimates. Compare ApoB-lowering treatments.
How is evinacumab taken?
Evkeeza is given by a healthcare professional as a 60-minute intravenous infusion every four weeks. The dose is based on body weight, which also affects drug quantity and cost. Prescribing information.
How does evinacumab compare with other medications?
Evinacumab lowers LDL through ANGPTL3 inhibition and can work despite severely impaired LDL-receptor function. That distinguishes it from therapies that rely heavily on LDL receptors. Lomitapide is an oral specialist alternative with different safety and monitoring requirements.
Which medications can be combined with evinacumab?
Evinacumab is added to other LDL-lowering treatments in HoFH, potentially including statins, ezetimibe, PCSK9-directed therapy, and LDL apheresis. A lipid specialist coordinates the full regimen rather than substituting it for all background treatment.
How much does evinacumab cost?
Request an individualized benefits review and infusion estimate. Weight-based dosing, infusion-site charges, and assistance eligibility prevent a single reliable out-of-pocket quote. Offers checked October 6, 2026; availability and eligibility can change.
myRARE / Evkeeza support
Request an individualized benefits review and infusion estimate. Weight-based dosing, infusion-site charges, and assistance eligibility prevent a single reliable out-of-pocket quote.
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Does insurance cover evinacumab?
Coverage for evinacumab varies by plan and formulation. These named formularies and medical policies were checked October 6, 2026; your plan’s rules and cost sharing may differ.
| Insurer | Coverage policy |
|---|---|
| UnitedHealthcare | UnitedHealthcare requires confirmed HoFH and specialist involvement. Adult criteria include LDL remaining at least 55 mg/dL despite specified statin, ezetimibe, and advanced-therapy trials or exceptions. Background treatment must continue; concurrent Juxtapid is not covered. Commercial medical-benefit policy, April 2026. |
| Aetna | Aetna requires precertification, specialist involvement, and documented HoFH. For adults, criteria include residual LDL elevation and stable maximally tolerated treatment with at least three lipid-lowering therapies, which must continue. Medical policy 0989. |
| Cigna | Cigna requires prior authorization for documented HoFH. Initial and continuation requests use different criteria; approval is generally for one year when the policy’s diagnosis, treatment, and dosing requirements are met. Drug coverage policy IP0128. |
| Anthem | Adult criteria require documented HoFH, maximally tolerated statin treatment or intolerance, and inadequate response or intolerance to ezetimibe and a PCSK9 inhibitor; LDL-receptor-negative genetic findings provide a PCSK9 exception. Clinical criteria CC-0193; confirm current plan adoption. |
| Blue Shield of California | Blue Shield of California requires prior authorization, specialist recommendation, confirmed HoFH, and background combination therapy. A PCSK9 inhibitor must have been inadequate, intolerable, or contraindicated, unless the patient has homozygous null-null variants. Infusion-site rules also apply. Commercial medical-benefit policy, July 2026. |
| BCBS of Texas | No listing for evinacumab was located in this named pharmacy formulary. This does not establish a denial; ask the plan about its current drug list, exceptions, and medical-benefit coverage. Performance Annual, 2026. |
What are the side effects of evinacumab?
Infusion reactions and serious hypersensitivity, including anaphylaxis, can occur. Nasopharyngitis, flu-like symptoms, dizziness, and nausea were reported. Evinacumab may harm a fetus; pregnancy testing and contraception counseling are part of treatment planning. Full safety information.
Does evinacumab reduce heart attacks or strokes?
The pivotal trial demonstrates LDL reduction in HoFH. A reduction in cardiovascular morbidity or mortality has not been established in a dedicated evinacumab outcomes trial. Its role reflects the extreme LDL burden and limited options in HoFH. Read the supporting evidence.
Is evinacumab right for you?
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