Evolocumab (Repatha)
Evolocumab (Repatha) is an injected PCSK9 antibody. In FOURIER, evolocumab lowered LDL cholesterol by 59% versus placebo at 48 weeks in patients already receiving statin therapy. Study results
How much does evolocumab lower LDL cholesterol?
Evolocumab lowered LDL cholesterol by 59% versus placebo at 48 weeks in FOURIER, on top of statin therapy. Read the evidence.
| Dose and treatment context | LDL result |
|---|---|
| 140 mg every two weeks or 420 mg monthly | 59% vs. placebo |
FOURIER enrolled patients with established atherosclerotic cardiovascular disease. The result is an add-on effect, not a comparison with starting a statin from an untreated baseline.
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 evolocumab taken?
For many adult indications, Repatha is injected under the skin at 140 mg every two weeks or 420 mg once monthly. The number of injections depends on the device and dose. HoFH regimens can differ. Prescribing information.
How does evolocumab compare with other medications?
Unlike Leqvio, Repatha can be self-injected after training and has direct cardiovascular outcome evidence. Praluent is another PCSK9 antibody; similar LDL reductions across separate trials do not establish identical results for every patient.
Which medications can be combined with evolocumab?
This treatment can be used on top of a statin, often with Ezetimibe. Combining multiple PCSK9-directed drugs is not a routine strategy; switching agents is different from taking them together. The choice depends on the needed LDL reduction, dosing preference, and insurance requirements.
How much does evolocumab cost?
Amgen advertises Repatha at $239 per month through its direct-to-patient cash program. Check the current program terms and prescribed regimen. Offers checked October 6, 2026; availability and eligibility can change.
AmgenNow
Amgen advertises Repatha at $239 per month through its direct-to-patient cash program. Check the current program terms and prescribed regimen.
GoodRx
Compare available pharmacy cash prices and coupons for the exact product and quantity. A pharmacy price may exclude administration charges and may differ from a manufacturer program.
Compare the cash price with your plan’s out-of-pocket quote for the same strength and quantity. Coupon purchases may not count toward your insurance deductible.
Does insurance cover evolocumab?
Coverage for evolocumab 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 | Repatha is Tier 2 with a quantity limit; the formulary row does not list prior authorization or step therapy. Commercial PDL, September 2026. |
| Aetna | Repatha SureClick is preferred brand with prior authorization and a limit of three pens per 28 days. Advanced Control, October 2026. |
| Cigna | Cigna lists Repatha at Tier 2; the formulary row has no prior-authorization or quantity-limit marker. A separate clinical authorization policy may apply. California Standard 4-Tier (DMHC), July 2026. |
| Anthem | Repatha SureClick is Tier 3 with prior authorization and a limit of three pens per 28 days. California Individual Select, October 2026. |
| Blue Shield of California | Repatha SureClick is Tier 2 with prior authorization and a limit of six pens per 28 days. Standard Formulary. |
| BCBS of Texas | Repatha is preferred brand with prior authorization and a limit of six pens or syringes per 28 days. Performance Annual, 2026. |
What are the side effects of evolocumab?
Injection-site reactions, upper respiratory symptoms, and back pain can occur. Serious allergic reactions are possible; people with a history of serious hypersensitivity to Repatha should not use it. Follow the device’s storage and injection instructions. Full safety information.
Does evolocumab reduce heart attacks or strokes?
In FOURIER, the primary cardiovascular composite occurred in 9.8% of patients taking evolocumab and 11.3% taking placebo over a median 2.2 years. That is a 1.5-percentage-point absolute reduction in patients with established cardiovascular disease. Read the supporting evidence.
Is evolocumab right for you?
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