Leqvio (Inclisiran): Cost, Dosing and LDL Results

Leqvio is the brand name for inclisiran, made by Novartis. The FDA approved it to lower LDL cholesterol in adults with high cholesterol, including people with familial hypercholesterolemia, an inherited form of very high LDL. A July 2025 label update also lets adults use it on its own, alongside diet and exercise.

Your liver makes a protein called PCSK9, which breaks down the LDL receptors that pull LDL out of your blood. Leqvio is a small interfering RNA (siRNA) that tells the liver to make less PCSK9, so the liver keeps more receptors and clears more LDL.

Repatha and Praluent are antibodies that grab PCSK9 after the liver has made it. Leqvio acts one step earlier and keeps working inside liver cells for months.

In the two main phase 3 trials, ORION-10 and ORION-11, about 3,200 people already on a statin got Leqvio or placebo. Leqvio lowered LDL cholesterol by 52% and 50% compared with placebo at about 17 months, and the effect held steady between doses.

Repatha lowered LDL about 60% in its main trial. The numbers come from different studies with different patients, so they don't make a perfect head-to-head comparison.

A healthcare professional gives Leqvio as a shot under the skin, usually in the belly, upper arm or thigh, so you skip self-injecting. The schedule is dose 1 on day one, dose 2 three months later, then one dose every six months.

Novartis lists three ways the drug reaches the clinic. In buy-and-bill, the clinic buys Leqvio, gives the shot and bills your insurance under the medical benefit (traditional Medicare Part B uses this route).

Some plans cover it under the pharmacy benefit, and a specialty pharmacy ships your dose to the clinic. An infusion center or similar site can also give the injection.

Direct proof is still pending. As of October 2026, the two large outcomes trials have no published results. ORION-4 randomized 16,124 people with established cardiovascular disease and showed no posted results on ClinicalTrials.gov. VICTORION-2 PREVENT, run by Novartis, lists an estimated primary completion of May 2027.

Leqvio's approval rests on how much it lowers LDL. Lower LDL has meant fewer heart attacks and strokes in major outcomes trials of drugs that work through LDL receptors. The 2026 ACC/AHA guideline calls inclisiran a valuable alternative for select patients requiring durable LDL-C lowering with infrequent dosing.

As of October 2026, Novartis lists Leqvio at $3,587.73 per dose for uninsured patients. At list price, that works out to about $10,760 in the first year (three doses) and about $7,180 a year after that (two doses). Many people pay less through coverage:

Repatha lowered LDL a little more in its main trial (about 60% vs about 50%) and has outcomes results from FOURIER and VESALIUS-CV. Leqvio needs two clinic visits a year after the first two doses, while Repatha is a shot you give yourself every 2 weeks or monthly.

Leqvio may be worth a conversation if you need more LDL lowering than a statin and ezetimibe provide and don't want to inject yourself, if you have trouble remembering medicines, or if you have Medicare and prefer Part B. Ask your clinician how each option fits your numbers and your coverage.