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cardiology general-medicine

PCSK9 Inhibitor Eligibility Assessment

Assesses eligibility for PCSK9 inhibitor therapy (evolocumab/alirocumab) per NICE TA394/TA385 criteria for high-risk cardiovascular patients.

Score interpretation

PCSK9 inhibitor not yet indicated

→ Optimise statin dose; add ezetimibe; lifestyle modification; recheck fasting lipids in 3 months; reassess if LDL-C remains above target

May meet NICE criteria — specialist review

→ Lipid clinic / cardiology referral; confirm FH diagnosis if applicable; ensure statin and ezetimibe maximally optimised; LDL-C check at least 3 months post-optimisation before prescribing

Likely NICE-eligible for PCSK9 inhibitor

→ Evolocumab 140mg SC Q2W or alirocumab 75-150mg SC Q2W; confirm NICE criteria met (LDL-C >3.5 with ASCVD or >5.0 with FH on max therapy); specialist initiation and review; LDL-C recheck at 3 months (target >50% reduction); NHS England prior approval pathway

Interpretation bands for the PCSK9 Inhibitor. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.