If your blood contains too much of the waxy substance called cholesterol, your risk of a heart attack or stroke from a clogged artery goes up. You may have inherited your high cholesterol, but diet and lifestyle choices can also be the cause. Either way, it’s in your best interest to reduce your cholesterol to a healthy level as soon as possible.
As with any medical condition, an aggressive treatment plan can come with a hefty price tag. To keep your spending down, research the financial costs of reducing high cholesterol and shop around to keep out-of-pocket costs manageable.
Diagnosis
A blood test called a lipid panel or lipid profile will show if your cholesterol is too high. Particles in your blood called lipoproteins carry cholesterol to your body’s cells that need it. A lipid panel gives separate numbers for:
- Total cholesterol
- LDL cholesterol, or low-density lipoprotein, also known as “bad” cholesterol
- HDL cholesterol, or high-density lipoprotein, often called “good” cholesterol
- Triglycerides, which are fats in your blood that come from foods
Your doctor may order a lipid panel as a standard part of your annual physical. Anyone over age 20 should get a cholesterol test at least every 5 years, regardless of overall health.
If you have private insurance that counts a physical as preventive care, a primary care doctor’s visit may cost you nothing. State Medicaid programs also may cover the checkup at little or no cost. But if you are uninsured or have Medicare (which does not pay for annual physicals), a primary care doctor’s visit in the U.S. usually costs $100 to $200.
Also, online research shows the median cost of a lipid panel ranges from $200 to $400 without insurance. If you decide to start monitoring cholesterol yourself between doctor visits, you can purchase a home test at your local pharmacy or medical supply store, usually for less than $20.
Medication
If your cholesterol levels are too high, your doctor first will urge you to make lifestyle changes: Avoid foods high in trans fats or saturated fats, tobacco, and sugar; exercise more, and drop extra weight. But if those lifestyle changes alone aren’t getting the job done, your doctor may prescribe one or more medications to reduce cholesterol.
The medications your doctor recommends will depend on your risk factors, age, and overall health. For some people with high cholesterol, treatment is all about the medications. Note: Most of the prices below are for average 30-day prescriptions, but they may vary if your dosage is higher or lower.
- Statins. These medications slow your liver’s cholesterol production and remove cholesterol from your blood. Statins available in the U.S. include:
- Atorvastatin (Lipitor): It can be as inexpensive as $8.25 with a coupon (or $2.48 with a typical 30% insurance copay)
- Fluvastatin (Lescol, Lescol XL): $43.10 ($12.93 copay).
- Lovastatin (Altoprev, Mevacor): $5.32 ($1.60 copay)
- Pitavastatin (Livalo, Zypitamag): $237.15 ($71.15 copay)
- Pravastatin (Pravachol): $8.21 ($2.46 copay)
- Rosuvastatin (Crestor): $10.15 ($3.05 copay)
- Simvastatin (Zocor): $4 price ($1.20 copay)
Your doctor also may prescribe another medication for you to take in combination with your statin. Examples are: Caduet (which combines atorvastatin with a blood pressure medication called amlodipine) or Vytorin (simvastatin plus a different cholesterol medication called ezetimibe). Prices for these combinations are a little higher: Caduet is around $37.40 ($11.22 copay) and Vytorin is around $64.70 ($19.41).
- Bile acid-binding drugs. These medications bind themselves to bile, a liver acid, which in turn makes your liver produce more bile that uses up cholesterol. They include:
- Cholestyramine (Questran, Questran Light): $32.70 ($9.81 copay)
- Colesevelam (WelChol): $30.50 price ($9.15 copay)
- Colestipol (Colestid): $22.66 ($6.80 copay)
- Inhibitor medications. These drugs either limit your small intestine’s ability to absorb cholesterol from food (absorption inhibitors) or help your liver absorb more LDL cholesterol (PCSK9 inhibitors). Some examples are:
- Alirocumab (Praluent): $371.70 ($111.51 copay)
- Evolucumab (Repatha): $476.64 ($142.99 copay)
- Ezetimibe (Zetia): $9.26 ($2.78 copay)
- Fibrates. These medications mostly reduce triglycerides rather than LDL cholesterol. Three commonly prescribed drugs are:
- Fenofibrate (Fenoglide, TriCor): $11.60 ($3.48 copay)
- Fenofibric acid (Fibricor, Trilipix): $25.40 ($7.62)
- Gemfibrozil (Lopid): $9.00 ($2.70 copay)
Individually, many of these medications aren’t expensive. But if you take several of them for a long time, or take one of the expensive newer drugs for high cholesterol, your out-of-pocket cost can add up.
For example, the Institute for Clinical and Economic Review believes no one’s total cholesterol medication bill should exceed $2,177 per year. If your drug costs are reaching that figure, you should price-shop aggressively.
Lifestyle Changes
Your doctor may ask you to:
- Cut back on red meat to avoid unhealthy saturated fats.
- Switch to healthier olive and canola cooking oils, which have healthier monounsaturated fats.
- Add more fresh vegetables, fruits, and grains to your diet.
- Take niacin (vitamin B3) or fish oil supplements.
Detailed eating plans like the DASH (Dietary Approaches to Stop Hypertension) and Mediterranean diets are a popular way to improve heart health. But reinventing your diet can fatten your grocery bill.
How much? The last research on heart-healthy diet costs points to an extra $1.50 to $2 per day spent on groceries. That means $547.50 to $730 more each year out of pocket.
Plus, about 2 1/2 hours of physical activity per week is standard guidance to people with high cholesterol. If you join a gym to get that exercise, you could be charged a $39 start-up fee and $10 a month (based on a national chain’s fees). That means $159 for your first year and $120 per year after that.
Supplements
You also may decide to talk with your doctor about adding certain supplements to your diet that are shown to lower cholesterol. Examples are:
- Barley. A bottle of 240 barley grass tablets is available online for as low as $5.99.
- Plant sterols and stanols. You can find options online priced anywhere from $14 to $42 per bottle, depending on the number of capsules or soft gels.
- Blond psyllium. An online search found a bottle of 360 capsules for $13.99.
- Oat bran. A bottle of 270 tablets can be found online for $14.19, and 8 ounces of powder for $6.99.
- Red yeast rice. You can find a bottle of 120 capsules online for $7.99
