Preval HealthAlready on a statin
Add to your statin, or switch, when LDL stays above goal.
For adults who take a statin and want their LDL cholesterol (LDL-C) and ApoB lower: add ezetimibe, bempedoic acid or a PCSK9 inhibitor, or switch to a different plan. A licensed clinician reviews your labs, you choose together, and we keep following your labs to reach goal and stay there.
Online, nationwide in the US. Protocols written by a board-certified preventive cardiologist.
How much lower do you need to go?
Start with the gap between your LDL now and your goal. Under the 2026 ACC/AHA guideline, most adults aim below 100 mg/dL, people at higher risk or with heart disease below 70, and people with heart disease at very high risk below 55. Your clinician picks the goal that fits you.
| LDL-C now | Drop to reach 100 | Drop to reach 70 |
|---|---|---|
| 130 mg/dL | 23% | 46% |
| 160 mg/dL | 38% | 56% |
| 190 mg/dL | 47% | 63% |
Percent drop = (LDL-C now minus goal) divided by LDL-C now. Goals from the 2026 ACC/AHA dyslipidemia guideline, simplified in our guide to lowering LDL.
What each medicine adds
Typical LDL lowering from the 2026 guideline summary. Your result depends on your starting point and your medicine, so treat these as averages.
- Moderate-intensity statinalone
- 30 to 49%
- High-intensity statinalone
- 50% or more
- Ezetimibe (pill)added to a statin
- about 25% more
- Bempedoic acid (pill)added to a statin
- 17 to 18% more
- PCSK9 antibodies: Repatha, Praluent (injection)on top of a statin
- 45 to 64%
- Inclisiran: Leqvio (injection)twice a year after the first year
- 48 to 52%
Add, switch or stay
Add
The most common choice. You keep the statin you tolerate and add a second medicine, so the two lower LDL together. Ezetimibe is the lowest-cost add-on. A PCSK9 inhibitor makes the biggest difference.
Switch
A better fit when a statin gives you side effects, or when you would rather take a different type of medicine. Options include a different statin, statin-free pills, or a PCSK9 inhibitor on its own.
Stay
If your LDL and ApoB already sit at your goal, the plan can stay as it is. A statin is the cheapest option with the longest track record.
How It Works
From your current statin to your goal
A board-certified preventive cardiologist designed our protocols. Licensed clinicians in our partner telehealth network deliver your care and write your prescriptions.
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 and a goal
Your clinician orders a lipid panel, ApoB and Lp(a) at a lab near you, or starts from recent results, and sets your LDL and ApoB goal from your risk.
Choose together, fill at a cash price
Your clinician shows how far your numbers sit from goal and which add-ons or switches close the gap. Generics go to your pharmacy. PCSK9 inhibitors go through manufacturer cash programs, with no step therapy or prior authorization.
Rechecks to reach goal and stay there
We recheck 4 to 12 weeks after each change and adjust. After that, a lipid panel and ApoB every quarter, with liver tests and creatine kinase every 6 months, keep you on track.
What it costs
Membership is $99 a month and covers your clinician, a lipid panel and ApoB every quarter, liver tests and creatine kinase every 6 months, rechecks after any change, and messaging. Medicines cost extra at cash prices as of October 2026: generic statins and ezetimibe about $10 to $20 a month, PCSK9 inhibitors about $199 to $356 a month.
Common questions
Can I switch from a statin to Repatha?
Repatha's label allows it alone or with other LDL-lowering medicines, so some people take it without a statin. Most people who need more LDL lowering add a PCSK9 inhibitor to a statin. In the FOURIER trial, everyone took a statin, and adding Repatha lowered LDL by 59% and reduced major cardiovascular events. Your clinician helps you choose.
Is a PCSK9 inhibitor better than a statin?
It lowers LDL more, about 50 to 60% compared with about 30 to 50% for a statin. Statins have the longest track record, the most outcome data and the lowest cost, so they stay first-line for many people. The two work well together.
Can I take ezetimibe with a statin?
Yes. Ezetimibe adds about 25% more LDL lowering to a statin, and combination pills exist. Ezetimibe is a generic, so the cash price at a pharmacy stays low.
Do I have to stop my statin to add another medicine?
No. Most people who add a second medicine keep the statin. Your clinician only suggests stopping it if it causes side effects or your numbers no longer need it.
How fast will I see a change?
A statin dose change shows most of its effect within 2 to 4 weeks. We recheck 4 to 12 weeks after every change, so you see the new number and your clinician adjusts the plan.
What if my statin gives me side effects?
Tell your clinician which statins you tried, at what doses, and what happened. Our statin intolerance protocol covers a careful rechallenge, statin-free pills and PCSK9 inhibitors.
What does it cost?
Membership is $99 a month for your clinician, labs, rechecks and messaging. Medicines are extra at cash prices as of October 2026: generic statins and ezetimibe about $10 to $20 a month, PCSK9 inhibitors about $199 to $356 a month.
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