Preval HealthPCSK9 Inhibitor Prescription
Get a PCSK9 inhibitor prescribed online, without an insurance wait.
A licensed clinician can prescribe Repatha, Praluent, Lipfendra or Lerochol after a telehealth visit, and a PCSK9 inhibitor can be your first medicine. You fill it at a cash price with no prior authorization or step therapy, and we check your labs every quarter.
Online, nationwide in the US. Protocols written by a board-certified preventive cardiologist.
What a PCSK9 inhibitor does
A PCSK9 inhibitor helps your liver clear more LDL cholesterol (LDL-C) from your blood. Added to a statin, these medicines typically lower LDL by about 50 to 60%.
Your liver makes a protein called PCSK9 that breaks down LDL receptors, the parts of liver cells that pull LDL cholesterol out of your blood. Blocking PCSK9, or making less of it, leaves more receptors working, so more LDL gets cleared.
As of October 2026, five are available. They differ mostly in how you take them and how much outcomes evidence each has so far.
- Repatha (evolocumab): Self-injection every 2 weeks or monthly. Outcomes trials (FOURIER, VESALIUS-CV) showed fewer heart attacks and strokes.
- Praluent (alirocumab): Self-injection every 2 or 4 weeks. Outcomes trial (ODYSSEY OUTCOMES) after a recent heart attack or unstable angina.
- Leqvio (inclisiran): Shot given in a clinic: first dose, again at 3 months, then every 6 months. Outcomes trials still in progress. We are working with infusion centers to offer it, so ask about availability in your area.
- Lipfendra (enlicitide): The first PCSK9 pill, FDA-approved in July 2026. Taken once daily on an empty stomach. Outcomes trial still in progress.
- Lerochol (lerodalcibep): Once-monthly self-injection, launched in the US in May 2026. Can be kept at room temperature for up to 3 months. Outcomes trial not yet reported.
Who typically qualifies
Insurance plans usually approve a PCSK9 inhibitor only after step therapy, a documented trial of a statin and often ezetimibe. Paying cash skips that rule. If a PCSK9 inhibitor fits your numbers and your preferences, you can start with one, and your clinician makes the final call based on your history.
The 2026 ACC/AHA cholesterol guideline sets an LDL-C goal below 70 mg/dL for people with cardiovascular disease, and below 55 mg/dL for those at very high risk. When LDL stays above goal on a statin, it recommends adding ezetimibe and/or a PCSK9 inhibitor without delay. You may be a candidate if you have:
- Heart or blood vessel disease (a prior heart attack, stent, bypass, stroke, or peripheral artery disease) with LDL-C still at or above 70 mg/dL on the highest statin dose you can tolerate
- Familial hypercholesterolemia, an inherited form of very high LDL
- Trouble taking statins, such as side effects on two or more statins, with LDL well above goal
- High LDL despite a statin and ezetimibe and a need for a larger reduction than pills alone provide
Your clinician decides whether a PCSK9 inhibitor is right for you, and sometimes a smaller step, like optimizing your statin or adding ezetimibe, gets you there first.
How You Pay
Cash pay, so you start sooner.
Preval runs as a cash practice. You fill a PCSK9 inhibitor through a manufacturer's direct program or a pharmacy at a cash price, with no prior authorization. Our care costs $99 a month on top of the medicine.
Manufacturer cash programs
As of October 2026: Lerochol $199 a month, Praluent $225, Repatha $239 through AmgenNow, and the Lipfendra pill at a list price of about $315. You see the price before you start.
PCSK9 inhibitor pricesTurned down by your insurer?
If your insurer denied a PCSK9 inhibitor, your deductible is high, or your plan covers these medicines poorly, you can start on the cash route right away.
How cash pay worksHow It Works
From first questions to follow-up labs
Sign up in a minute, see a licensed clinician by video to confirm it's a fit, get labs, start treatment at a cash price, and recheck labs every quarter.
Sign up in a minute
Tell us your state, name and email. When care opens in your state, a quick eligibility check comes before you pay. Preval handles prescription lipid management only, and your clinician takes your health history at the visit.
A video visit, if it's a fit
A licensed clinician from our partner telehealth network meets with you by video, takes your history and checks that Preval is a good fit, following protocols written by a board-certified preventive cardiologist. If it isn't a fit, you get a full refund and advice on where to go instead.
Labs, or recent results
If you need a fresh lipid panel, ApoB or Lp(a), your clinician orders it at a lab near you. Recent results from your own doctor or a lab-testing service work too. Your clinician then decides whether a PCSK9 inhibitor makes sense, or whether another step fits better first.
Start your medicine at a cash price
The prescription goes through a manufacturer's direct program or a pharmacy at a cash price, with no prior authorization or step therapy, and you see the price before you start. A healthcare professional gives Leqvio in person; we are working with infusion centers to offer it.
Quarterly labs and adjustments
We recheck your labs every quarter and adjust treatment to your numbers, so you know whether you have reached your goal and what comes next if you haven't.
Common questions
Is a PCSK9 inhibitor a statin?
No. PCSK9 inhibitors are a different class of medicine. Statins slow the liver's own cholesterol production, while PCSK9 inhibitors help the liver keep more LDL receptors so it clears more LDL from the blood. They are usually added on top of a statin, or used instead of one when a statin can't be tolerated.
Can I get Repatha prescribed online?
Yes. A PCSK9 inhibitor like Repatha can be prescribed through a telehealth visit, the same way many other prescriptions are. You still need an evaluation: a licensed clinician reviews your history and recent labs before writing a prescription. At Preval Health, licensed clinicians in our partner telehealth network write prescriptions, following protocols written by a board-certified preventive cardiologist.
Who qualifies for a PCSK9 inhibitor?
Adults with high LDL can take one. The FDA labels for Repatha and Praluent allow them alone or with other cholesterol medicines, so a statin doesn't have to come first. Insurance plans usually add step therapy, requiring a statin and often ezetimibe first. Paying cash skips those plan rules, so you and your clinician choose on medical grounds, and a PCSK9 inhibitor can be your first medicine. The 2026 ACC/AHA guideline also recommends adding ezetimibe and/or a PCSK9 inhibitor without delay when LDL stays above goal on a statin.
Does Preval handle insurance approval?
Preval runs as a cash practice, so we don't file prior authorizations or appeals. Through insurance, approval for a PCSK9 inhibitor can take weeks, and a denial and appeal can take months. Paying cash through a manufacturer program skips that wait. If your insurer already said no, you're welcome here.
Can I pay cash for a PCSK9 inhibitor instead of using insurance?
Yes. Some manufacturers sell directly to patients with a valid prescription and no prior authorization. As of October 2026, Amgen's AmgenNow program offers Repatha (launched at $239 a month in October 2025) and LIB Therapeutics offers Lerochol at $199 a month. These purchases generally do not count toward your insurance deductible. With Preval, you fill this way, and our care costs $99 a month on top of the medicine.
Do I need to see a cardiologist to get a PCSK9 inhibitor?
No. Any licensed prescriber can prescribe a PCSK9 inhibitor. At Preval Health, a board-certified preventive cardiologist wrote the treatment protocols, and licensed clinicians in our partner telehealth network evaluate you and write the prescription.
Is online enrollment faster than going through my doctor for cholesterol injection support?
It can be, mostly because Preval skips the insurance steps. Through insurance, approval for a PCSK9 inhibitor can take weeks, and a denial and appeal can take months. Preval runs as a cash practice, so there's no prior authorization or step therapy to wait on. You start online without a referral. You have a telehealth visit with a licensed clinician from our partner network, share your history and any recent labs, and get blood drawn at a local lab if you need new ones. If a cholesterol injection fits, the prescription goes to a pharmacy or a manufacturer's direct cash program. Care costs $99 a month, and the medicine is paid separately at a cash price, about $199 to $356 a month for PCSK9 inhibitors as of October 2026. We're opening spots in stages, so the first step today is joining the waitlist. Your own doctor is still a good route, especially if your insurance covers the medicine.
Can I contact a cholesterol injection care specialist directly?
Yes. You don't need a referral. Sign up with Preval directly, and as a member you can message your care team with questions between visits. Licensed clinicians in our partner telehealth network deliver your care, following treatment protocols written by a board-certified preventive cardiologist, and they can prescribe cholesterol injections such as Repatha, Praluent, or Lerochol when one fits. We're opening spots in stages, so you start by joining the waitlist, and you can email support@prevalhealth.com with questions before then.
How often will I need lab tests?
We check labs every quarter. Those results show whether the medication works and whether you have reached your goal, so your clinician can adjust the plan.
Find out if a PCSK9 inhibitor fits.
We're rolling out slowly and taking a limited number of patients. Join the waitlist to get an early spot.
Join the Waitlist