Leqvio Cost, Dosing, and LDL Results: Twice-a-Year Shot

What is Leqvio used for?

Leqvio is the brand name for inclisiran, a cholesterol-lowering medicine made by Novartis. It treats high LDL cholesterol. The FDA approved it to lower LDL cholesterol (the "bad" cholesterol that builds plaque in arteries) in adults with high cholesterol, including people with familial hypercholesterolemia, an inherited form of very high LDL.

Few cholesterol medicines come as rarely as Leqvio. After the first two doses, a healthcare professional gives it as a shot every six months, twice a year. A July 2025 label update also lets adults use it on its own, alongside diet and exercise.

This timeline shows how often each option is taken over a year.

How does Leqvio work?

Leqvio tells your liver to make less PCSK9, a protein that destroys LDL receptors, so the liver clears more LDL from your blood. Scientists call it a small interfering RNA, or siRNA.

Your liver makes a protein called PCSK9. PCSK9 breaks down LDL receptors, the proteins on liver cells that pull LDL out of your blood. With less PCSK9, the liver keeps more receptors and clears more LDL from your bloodstream.

Repatha and Praluent are antibodies that grab PCSK9 after the liver has made it. Leqvio works one step earlier: it silences the genetic message the liver uses to build PCSK9 in the first place. Because it acts inside liver cells and lasts a long time there, one dose keeps working for months.

How much did LDL go down in Leqvio clinical studies?

Leqvio lowered LDL cholesterol by about 50% compared with placebo. In the two main phase 3 trials, ORION-10 and ORION-11, about 3,200 people already on a statin got Leqvio or placebo. Leqvio lowered LDL cholesterol by 52% and 50% compared with placebo at about 17 months, and the effect held steady between doses.

Repatha lowered LDL a little more, about 60% in its main trial, though the numbers come from different studies with different patients, so they aren't a perfect head-to-head comparison.

Does Leqvio reduce heart attacks? Where the outcomes trials stand

Not yet proven. The trials that count heart attacks and strokes for Leqvio haven't reported.

An outcomes trial counts heart attacks, strokes, and deaths, beyond cholesterol numbers. Repatha and Praluent both have one. Leqvio's are still running:

• ORION-4 randomized 16,124 people with established cardiovascular disease in the UK and US, led by the University of Oxford. As of October 2026, ClinicalTrials.gov showed no posted results (ClinicalTrials.gov NCT03705234).
• VICTORION-2 PREVENT, run by Novartis, lists an estimated primary completion of May 2027 (ClinicalTrials.gov NCT05030428).

The 2026 ACC/AHA cholesterol guideline describes inclisiran as "a valuable alternative for select patients requiring durable LDL-C lowering with infrequent dosing" (ACC).

How often do you get Leqvio, and who gives it?

You get Leqvio twice a year after two starter doses. A healthcare professional gives it as a shot under the skin, usually in the belly, upper arm, or thigh, so you skip self-injecting. The schedule:

• Dose 1: day one
• Dose 2: three months later
• Then: every six months

How the drug gets to the clinic depends on your insurance. Novartis lists three routes (Leqvio Access):

• Buy-and-bill: the clinic buys Leqvio, stores it, gives the shot, and bills your insurance under the medical benefit. Traditional Medicare (Part B) requires this route.
• Specialty pharmacy: some plans cover it under the pharmacy benefit, and a specialty pharmacy ships your dose to the clinic.
• Alternate site of care: an infusion center or similar site gives the injection.

For a telehealth practice, that means the prescription and follow-up can happen by video, but the shot itself is given in person at a clinic or infusion site.

How much does Leqvio cost per year, with and without insurance?

As of October 2026, Novartis lists Leqvio at $3,587.73 per dose for uninsured patients (Leqvio.com). At list price, that's about $10,760 in the first year (three doses) and about $7,180 a year after that (two doses).

Very few people pay that. Coverage usually works this way:

• Medicare: when Leqvio is given in a clinic, it's usually covered under Part B. Novartis says traditional Medicare may cover it, and without a supplemental plan you owe 20% coinsurance (Leqvio.com). Medicare.gov adds that you usually pay that 20% after meeting the Part B deductible (Medicare.gov). Medicare Advantage costs vary by plan, and a Medigap or supplemental plan may cover some or all of the 20%.
• Commercial insurance: usually requires prior authorization, similar to Repatha. Novartis's co-pay program helps eligible commercially insured patients; it excludes Medicare, Medicaid, TRICARE, VA, and other government plans, and per-treatment and yearly limits apply. Novartis reports that 75% of commercial patients paid less than $10 and 86% of those using the program paid $0 (Leqvio.com). Novartis does not publish a typical yearly cost after insurance, so a per-year figure depends on your plan's coverage and the program's limits, which the program terms do not list in dollars (terms).
• Uninsured: The Novartis Patient Assistance Foundation provides Novartis medicines free to eligible patients with limited or no prescription coverage who meet income and insurance guidelines (Leqvio Care Program).

For a full breakdown of what the other options cost, see our Repatha cost guide.

Leqvio vs Repatha: which one lowers LDL more?

Repatha lowers LDL a little more than Leqvio in their main trials and has outcomes results, but Leqvio needs only two shots a year instead of one every 2 to 4 weeks. That twice-yearly schedule is the main difference from the monthly and every-2-week injections. Praluent, Lipfendra, and Lerochol join them in the table below. All five medicines work on PCSK9.

Praluent's dosing is from its prescribing information (Sanofi). Lipfendra's numbers come from Merck's phase 3 CORALreef trials, and its outcomes trial, CORALreef Outcomes, is still running (ClinicalTrials.gov NCT06008756). Lerochol's LDL-C figure is from its pivotal trial compared with placebo over a year (TCTMD); LIB Therapeutics announced a direct-to-patient cash price of $199 a month at its US launch on May 11, 2026 (LIB Therapeutics), and no cardiovascular outcomes trial has reported as of October 2026. LDL-C numbers come from different trials with different patients, so treat them as ballpark figures. Repatha's outcomes evidence comes from FOURIER and VESALIUS-CV, and Praluent's from ODYSSEY OUTCOMES, which found a 15% lower risk of major cardiovascular events after a recent heart attack or unstable angina.

Who might choose Leqvio over Repatha?

Leqvio is worth a conversation if you:

• Need more LDL lowering than a statin and ezetimibe provide, and don't want to inject yourself every few weeks
• Have trouble remembering medicines, since two clinic visits a year are hard to miss
• Have Medicare and would rather use Part B coverage than Part D
• Have had side effects with statins and want a non-statin option (Leqvio can now be used on its own)

You might lean toward Repatha or Praluent instead if outcomes evidence matters most to you right now, or if getting to a clinic twice a year is harder than a quick shot at home. If needles are the problem, Lipfendra is a daily pill. If you want fewer home shots, Lerochol is once a month. Our Repatha alternatives guide compares every option, including the oral Lipfendra, and PCSK9 inhibitors explained covers the whole class.

How Preval Health helps

Preval Health focuses only on prescription cholesterol care. A board-certified preventive cardiologist writes our treatment protocols, and licensed clinicians through our partner telehealth network write the prescriptions.

We are working with infusion centers to offer Leqvio. We're still setting that up, so if Leqvio interests you, ask us about availability in your area. Preval runs as a cash practice and doesn't file insurance claims or prior authorizations. If another medicine fits better, such as an at-home injection or a daily pill, a partner clinician prescribes it through manufacturer cash programs. Care costs $99 a month, and you pay the medicine's cash price. Whatever you take, we check your labs every quarter, and your clinician adjusts treatment to your numbers. See how to get a PCSK9 inhibitor prescription online for the step-by-step version.