Meet the new lipid-lowering agents: monoclonal antibodies that promise to shrink LDL to levels lower than even the strongest statin could achieve.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have captured attention for their potential to cut stroke and myocardial infarction risk, as well as for their substantial cost, an estimated $8000 per year.

In Australia, just one of the two available in the class, evolocumab (Repatha, Amgen), is subsidised by the PBS and then only for patients with familial hypercholesterolaemia.

Last year the federal Department of Health rejected an application for the drug to be funded for secondary prevention in patients who had already experienced an MI or acute coronary syndrome (ACS).