Preval HealthPrices as of October 2026
PCSK9 inhibitor prices without insurance (2026)
PCSK9 inhibitor prices without insurance now run from $199 to about $315 a month. Lerochol is $199 a month direct from its maker, Praluent is $225 through GoodRx, Repatha is $239 through AmgenNow, and the Lipfendra pill lists at about $315. Each one still requires a prescription.
Online, nationwide in the US. Protocols written by a board-certified preventive cardiologist.
Prices last verified October 2, 2026, on each program's own site or the coverage cited below.
Which PCSK9 inhibitor is cheapest without insurance?
Lerochol is the cheapest PCSK9 inhibitor without insurance, at $199 a month through LEROCHOL Direct as of October 2026. You also inject it just once a month: 12 shots a year, against 26 for an every-2-weeks injection.
The lowest price may not suit you best. Praluent and Repatha have the longest track records, including large heart outcome trials, and Lipfendra suits people who'd rather skip injections entirely. Only $40 a month separates the cheapest and priciest injections, so how you want to take it often matters more than the price.
PCSK9 inhibitor cash prices, side by side
What each PCSK9 inhibitor costs if you pay cash, where that price comes from, and what you need to use it.
| Medicine | How it's taken | Cash price | Per year | Program | What you need |
|---|---|---|---|---|---|
| Lerochol (lerodalcibep) | One injection a month (prefilled syringe; an autoinjector pen is expected by January 2027) | $199 a month Source: lerochol.com | $2,388 | LEROCHOL Direct, from LIB Therapeutics, filled by HealthDyne, a licensed pharmacy | Needs a prescription. The program doesn't say whether it counts toward a deductible, so ask your plan. |
| Praluent (alirocumab) | Injection every 2 weeks (or a monthly dose); one carton holds 2 pens | $225 for a 2-pen carton (about a month) Source: GoodRx | $2,700 | Self-pay price on GoodRx, set with Regeneron | Needs a prescription. The same $225 price was announced for TrumpRx in April 2026. |
| Repatha (evolocumab) | Injection every 2 weeks with the SureClick autoinjector (2 pens a month) | $239 a month Source: TrumpRx and AmgenNow | $2,868 | AmgenNow (a GoodRx coupon at a participating pharmacy) or the TrumpRx coupon | Needs a prescription. If you have Medicare or Medicaid, you agree not to count it toward your deductible or out-of-pocket limit. |
| Lipfendra (enlicitide) | One pill a day, on an empty stomach | About $315 a month (list price, $10.50 a day) Source: Chicago Sun-Times | About $3,830 | List price from Merck; we couldn't confirm a direct cash program | Needs a prescription. Pharmacy cash prices can differ from list price. |
For comparison, the cholesterol pills that come before a PCSK9 inhibitor cost far less. Generic ezetimibe is about $6 for 30 tablets at Mark Cuban Cost Plus Drugs before shipping, and generic statins are in the same range there. Statins remain the first-line and cheapest treatment. If you can't take one or have decided against one, weigh the options above.
Prices are what each program listed when we checked on October 2, 2026, and they can change. Per-year figures are the monthly price times 12 (Lipfendra: $10.50 a day times 365). Sources: LEROCHOL Direct, LIB Therapeutics launch, GoodRx Praluent, White House Regeneron fact sheet, AmgenNow, Amgen press release, TrumpRx Repatha, Chicago Sun-Times on Lipfendra.
How do direct-to-patient cash programs work?
You get a prescription, then pay the drugmaker's set price at a participating pharmacy or the program's own pharmacy, with no insurance claim, no prior authorization, and no step therapy. The price is the same whether or not you have insurance.
AmgenNow (Repatha). You download a discount coupon through GoodRx, show it at a participating pharmacy with your prescription, and pay $239. Amgen says people who use it aren't subject to insurer step therapy or prior authorization rules (Amgen). TrumpRx offers the same $239 price as a coupon you present at the pharmacy.
LEROCHOL Direct (Lerochol). Your clinician sends the prescription to the program, and HealthDyne, a licensed pharmacy, fills it for $199 a month (lerochol.com). Lerochol can be kept at room temperature for up to three months (LIB Therapeutics).
Praluent self-pay. GoodRx lists a $225 self-pay price for a 2-pen carton, set with Regeneron. When we checked TrumpRx, Praluent wasn't listed there yet, so GoodRx is the route we could confirm.
Lipfendra. Merck set the list price at $10.50 a day. We couldn't confirm a direct cash program for it as of October 2026, so the price you pay depends on the pharmacy.
One catch: these programs sit outside your insurance. If you have Medicare or another government plan, AmgenNow and TrumpRx ask you to agree not to bill your plan or count the cost toward your deductible, and TrumpRx asks you to buy through the program for the rest of the calendar year (TrumpRx).
Do you still need a prescription and lab checks?
Yes. Every PCSK9 inhibitor is prescription-only, cash or not, and a follow-up lipid panel shows whether the medicine is working.
Paying cash skips the insurance paperwork, and the medical steps stay the same. Someone has to check that a PCSK9 inhibitor fits your history, pick the dose, show you how to take it, and recheck your LDL cholesterol (LDL-C) and ApoB to see how far they've come down. People respond differently, and if your numbers aren't at target, the plan should change.
If you already have a doctor who'll write the prescription, you can use any of these programs directly. If you don't, our partner clinicians can. See how a PCSK9 inhibitor prescription works online.
How does Preval Health fit in?
We handle the care, and you pay the drug program directly. A licensed clinician evaluates you by video, prescribes the PCSK9 inhibitor that fits, sends it to the right cash program, and rechecks your labs every quarter.
- Picking the option. Lerochol often makes sense for cash pay, since it has the lowest monthly price and it's one shot a month. Praluent or Repatha make sense if you want the longest outcome data, and Lipfendra if you won't inject.
- Quarterly labs. We order your lipid panel, ApoB, and other tests at a lab near you, and adjust the plan from the results.
- Honest about statins. Statins are first-line and the cheapest option, and we'll say so. If you've decided against one, we respect that and work from there.
- Insurance, if it's cheaper. Preval runs as a cash practice and doesn't file prior authorizations. If your plan would likely cover a PCSK9 inhibitor for less, we'll say so, and your own doctor can pursue that route.
The medication price goes to the manufacturer's program or the pharmacy instead of us. Our care costs $99 a month. A board-certified preventive cardiologist writes the protocols, and licensed clinicians in a partner telehealth network deliver your care. More on how cash pay works.
When is insurance cheaper than paying cash?
If your commercial plan approves a PCSK9 inhibitor, a manufacturer copay card usually beats any cash price. With Medicare, compare your Part D cost with the cash price, since copay cards can't be used.
Commercial insurance. Amgen's Repatha copay card says eligible patients may pay as little as $5 a month (Repatha.com), and Regeneron runs a similar MyPRALUENT copay card. The catch is getting approved first: most plans want documented statin and ezetimibe trials and a prior authorization. If that wait is the problem, cash avoids it. See what Repatha costs on each path.
Medicare. Manufacturer copay cards aren't valid when Medicare or any federal or state program pays for any part of the prescription (Repatha.com). Part D has its own protection: once your out-of-pocket spending on covered drugs reaches $2,100 in 2026, you pay nothing more for covered drugs that year (Medicare.gov). Over a full year that can come out below a $199 to $239 monthly cash price, so run both numbers.
High deductibles or no coverage. Cash programs help most here, with a known monthly price, no approval wait, and no surprise bill at the counter.
Common questions
What is AmgenNow?
AmgenNow is Amgen's direct-to-patient cash program. As of October 2026, it prices Repatha at $239 a month. You get a prescription, download a discount coupon through GoodRx, and pay that price at a participating pharmacy, with no insurance claim and no prior authorization. Anyone with a prescription can use it, including people who are uninsured, on a high-deductible plan, or who simply prefer to pay cash.
What is the cheapest PCSK9 inhibitor without insurance?
As of October 2026, Lerochol (lerodalcibep) has the lowest cash price we could verify: $199 a month through LIB Therapeutics' LEROCHOL Direct program, with a prescription. Praluent is $225 for a month's carton of 2 pens, Repatha is $239 a month through AmgenNow, and the Lipfendra pill has a list price of about $315 a month.
How much does Lerochol cost?
Lerochol costs $199 a month through LEROCHOL Direct, LIB Therapeutics' cash-pay program, as of October 2026. You need a prescription, and HealthDyne, a licensed pharmacy, fills it. The FDA approved an autoinjector pen on August 17, 2026, and LIB Therapeutics expects it by January 2027 at the same $199 a month.
What is Praluent's cash price?
As of October 2026, GoodRx lists Praluent at $225 for a carton of 2 pens, about a month at the every-2-weeks dose, for self-pay patients, through a partnership with Regeneron. In April 2026 the White House announced the same $225 price for Praluent bought through TrumpRx.
How much is Repatha without insurance?
Repatha is $239 a month without insurance through AmgenNow, as of October 2026. TrumpRx lists the same $239 for two 140 mg SureClick autoinjectors, a month's supply at the every-2-weeks dose. Both work as a coupon you show at the pharmacy along with your prescription.
Does a cash price count toward my insurance deductible?
Assume it won't count. AmgenNow and TrumpRx both say that people with Medicare, Medicaid, or other government coverage must agree not to count the purchase toward their deductible or out-of-pocket costs. TrumpRx tells people with commercial insurance to check with their plan. LEROCHOL Direct and the GoodRx Praluent price don't say either way, so ask your plan before you rely on it.
Can I use a cash program if I have Medicare?
AmgenNow says it's available to anyone with a prescription, but if you have Medicare you agree not to bill your plan, not to count the cost toward your deductible or out-of-pocket limit, and to tell your plan you bought the medicine outside it. Compare that with your Part D plan first: out-of-pocket spending on covered Part D drugs is capped at $2,100 in 2026.
Is there a generic PCSK9 inhibitor?
No. Repatha and Praluent are antibody medicines with no generic or biosimilar in the US yet, and Lerochol and Lipfendra are new brands. The cheap generic cholesterol pills belong to other classes: statins, and ezetimibe, which Mark Cuban Cost Plus Drugs lists at about $6 for 30 tablets before shipping, as of October 2026.
Does Preval sell the medication?
No. You pay the medication price straight to the manufacturer's program or the pharmacy, separately from us. We provide the care. A licensed clinician prescribes, orders labs every quarter, and adjusts the plan. Our care costs $99 a month.
Is there a cash price for Leqvio?
We couldn't find a direct cash program for Leqvio (inclisiran). Clinics give it as a shot, twice a year after the first two doses, so they usually bill it through insurance. We're working with infusion centers to offer it.
Licensed clinicians prescribe, and we continue to follow you.
We're rolling out services slowly and taking a limited number of patients. Join the waitlist to get an early spot.
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