30-50% of middle-aged adults face heart attack/stroke risk; existing PCSK9/statins can lower to <10% but systemic friction prevents uptake
LDL accumulation is silent and asymptomatic until catastrophic event. PCSK9 inhibitors offer superior risk/reward vs statins (genetic evidence of safety at near-zero LDL). Compliance is the barrier: silent benefit + chronic dosing + system friction. Oral/quarterly formulations and direct access models (like GLP-1) could unlock mass preventive adoption.
PCSK9 inhibitors are a 'free lunch' with 88% CVD risk reduction in genetic models, destined to exceed GLP-1 market long-term
Human genetic knockouts show 88% CVD risk reduction with lifelong PCSK9 deficiency; drugs achieve 50% LDL lowering and 20-25% event reduction in outcome trials. Unlike GLP-1s, minimal side effects (no nausea, muscle loss) and silent asymptomatic benefit create compliance challenge but superior risk/reward. Earlier intervention compounds benefit exponentially.