OBJECTIVES: Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors can significantly lower the levels of low-density lipoprotein cholesterol. Early evidence suggests that the use of PCSK9 inhibitors reduces the incidence of major adverse cardiovascular events (MACE). Our objective was to determine the preliminary economic implications of using these drugs to improve health outcomes. METHODS: We used the outcomes data of patients enrolled in the OSLER and ODYSSEY LONG TERM trials to estimate the potential reduction of MACE in untreated patients. The costs were estimated based on the trials follow-up data and current US costs of drugs. We compared the costs of MACE prevention with PCSK9 drugs to using potent statin drug as primary prevention, and the cost of preventing one death to the cost of curing one patient with novel Hepatitis C drugs. RESULTS: Using PCSK9 inhibitors in the 4,529 patients enrolled in both trials would result in the prevention of 35 MACE in a total of 4903 patient years: 8 cardiovascular deaths, 22 myocardial infarctions, 0 strokes and 5 unstable anginas. The cost of using these drugs would have been $70,172,141 during those years of follow-up. Therefore, the cost of preventing one MACE is $2,004,918 and one death would be $8,777,518, one hundred fold higher curing one patient with the novel Hepatitis C drugs. CONCLUSIONS: Using PCSK9 inhibitors to prevent MACE seems to be a very expensive strategy. Assuming that the upcoming outcome trials will demonstrate similar results, it seems that these drugs do not provide good value for money.