INCLISIRAN FOR CHOLESTEROL | Docs call it expensive, bat for cheaper options

New Delhi, Jan 14:  Even as India is set to soon launch promising new DCGI and US FDA-approved medicine Inclisiran to lower cholesterol and keep it low with just two doses a year, doctors, while hailing the advance, contend that the drug is expensive and stressed on better use of the much cheaper versions available.

Inclisiran is the first and only small interfering RNA (siRNA) therapy to lower low-density lipoprotein cholesterol (also known as bad cholesterol or LDL-C) with two doses a year, after an initial dose and one at three months.

Manufactured by Swiss multinational pharmaceutical Novartis and expected to cost around Rs 1.2 lakh, it has been approved by the Drug Controller General of India (DCGI) under the brand name of Sybrava, following the successful completion of trials. The UK has also approved Inclisiran.

"There is a case for use of these injectables in India if their price comes down. As of right now, even the use of appropriate doses of statins is not so common in India. These are cheap medicines which are available in generic form in India and they are still not used so at the moment, one should focus on how to use them better," Dr Vivek Chaturvedi, Head, Department of Cardiology, Amrita Hospital, Faridabad, told IANS.

"The use of these injectables will only take place for those people in India who find too many side effects of statins. The reason being that, for most Indians, cholesterol is controlled using statins which are much cheaper," he added.

Inclisiran is able to reduce the amount of LDL-C in the bloodstream by improving the liver’s natural ability to prevent the production of a protein that plays a role in keeping circulating cholesterol levels high.

It is a subcutaneous injection with an initial dose, then again at three months, and then every six months. This approach may help those who have trouble sticking to medicines that are self-administered and have greater dosing frequency.

"Inclisiran is a new cholesterol-lowering drug administered subcutaneously twice yearly. Being both very expensive and a very potent drug, its use will initially be restricted to those patients with severely raised blood cholesterol levels that don’t respond to current orally administered pills," Dr Atul Mathur, Executive Director-Interventional Cardiology & Chief of Cath Lab, Fortis Escorts Hospital, New Delhi, told IANS.