PCSK9 and atherosclerosis: Whether and to what degree health care insurers will facilitate approval of PCSK9 class of medications [11, 14, 16] at an annual price of $14,000–14,600 per patient may ultimately be determined by the outcomes of placebo-controlled trials of hard CVD endpoints and all-cause mortality [13] or surrogate CVD endpoints such as regression or non-progression of atherosclerosis by intravascular ultrasound.