PCSK9 and familial hypercholesterolemia: Government affordability also improved to about $5,000/QALY, superior to many other federally approved health interventions including drug treatment of hypertension ($20,000/QALY [46]), use of statins for primary prevention ($37,000/QALY [28]), and adding PCSK9 inhibitors to statins in patients with CVD ($414,000/QALY) or heterozygous familial hypercholesterolemia ($503,000/QALY) [47].