Appropriate use of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors for atherosclerotic cardiovascular disease: Comparison of recommendations from different guidelines or consensus around the world

Increased low-density lipoprotein cholesterol (LDL-C) is the most crucial risk factor for atherosclerotic cardiovascular disease (ASCVD). Statins are the mainstay therapy, but many patients need to add non-statin treatment to reach the recommended LDL-C goal. Although proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are the most effective agents in LDL-C reduction, they are much more expensive than other lipid-lowering agents. In January 2020, the Taiwan National Health Insurance (NHI) program started to reimburse PCSK9 inhibitors for select ASCVD patients with certain conditions. Major guidelines or consensus worldwide also provide specific recommendations about how to appropriately use these agents. This review summarizes the Taiwan NHI regulations of using PCSK9 inhibitors and compared them with other guidelines or consensus around the world.