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" ... James Stein said that it "makes sense with everything we know from pathophysiology and other clinical trials" that "people with higher LDL may have benefited more." He said that PCSK9 inhibitors are safe and effective but that "the challenge will be figuring out the subgroups of who benefits the most and convincing payers to cover this medication at its current price."In the meantime," said Stein, "I will continue to add ezetimbe to high dose statin and maximize lifestyle changes, reserving these wonderful new medications for those with the highest LDL values or highest risk. If their price were lower, however, it would be a no-brainer to use them much more. We have proven efficacy and safety in the medium term now, so cost is the major barrier." ... "