Policosanol is a natural mixture of long-chain waxy alcohols, usually extracted from the wax that coats sugar cane. Its main component is octacosanol, with smaller amounts of related alcohols such as triacontanol, hexacosanol and tetracosanol. Similar compounds are found in beeswax, rice bran and wheat germ, but sugar cane is the most common source in supplements.
Policosanol first attracted attention through a series of studies from Cuba that reported changes in cholesterol levels. Later independent trials, including a large randomised trial published in JAMA in 2006, did not find meaningful differences compared with placebo. EFSA reviewed the evidence in 2011 and concluded that a link with normal cholesterol had not been established.
So the honest picture is mixed. Researchers have studied policosanol for its role in normal cholesterol levels, but the results have not held up consistently. It is usually sold in small tablets or capsules, often in heart-focused formulas alongside plant sterols, red yeast rice or other ingredients, and labelled as policosanol, sugar cane wax extract or octacosanol.