Cost-effectiveness and Budget Impact of Treatment with Evolocumab Versus Statins and Ezetimibe for Hypercholesterolemia in Spain

Lima, Antonio Olry de Labry; Ballester, Vicente Gimeno; Sánchez, Jesús Francisco Sierra; Hoces, Antonio Matas; González-Outón, Julio; Rey, EJ Alegre-Del

doi:10.1016/j.rec.2018.05.003

Cited by 8 publications

(13 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Further details for the cost adaptation process can be found in Appendix 3 (see ESM). Studies that did not report the cost year [26][27][28][29][30] were excluded for adaptation. Authors from studies not reporting cost year were contacted by e-mail in an effort to complete the missing data.…”

Section: Cost Adjustments Methodsmentioning

confidence: 99%

“…Among the 15 selected studies evaluating PCSK9 inhibitors, three were updates from previous published models incorporating new clinical or pricing data [38,44,48], and the rest were original research articles. Eight studies were set in the US [12,26,29,37,38,43,44,48], two in Spain [30,39], and the rest in Japan [46], Norway [33], Australia [47], Germany [28] and Thailand [45]. The comparator was statins or statins plus ezetimibe.…”

Section: Proprotein Convertase Subtilisin/kexin Type 9 (Pcsk9) Inhibimentioning

confidence: 99%

“…The mean age of the population was > 60 years in all the included studies and baseline LDL-C levels ranged from 70 to 150 mg/dL. All the studies used a Markov model with yearly cycles except Kumar et al [47], who modelled 5-year cycles, and all used lifetime horizons with the exception of Olry de Labry Lima et al [30], who used a 10-year time horizon [30]. The model structure varied, with studies simulating from three [45] to eleven [39] health states, and important differences in the variety of the included cardiovascular events, with fatal and non-fatal myocardial infarction and fatal and non-fatal stroke modelled in 13 studies [12,26,28,33,[37][38][39][43][44][45][46][47][48].…”

Section: Proprotein Convertase Subtilisin/kexin Type 9 (Pcsk9) Inhibimentioning

confidence: 99%

See 2 more Smart Citations

743 WITHDRAWN:Â Novel Treatment Strategies for Secondary Prevention of Cardiovascular Disease: A Systematic Review of Cost-Effectiveness

2020

Heart, Lung and Circulation

View full text Add to dashboard Cite

Background New pharmacological therapies for the treatment of cardiovascular disease (CVD) have emerged in recent years. The high rates of CVD and the need for long-term treatment to decrease risk factors makes cost-effectiveness crucial for their successful long-term implementation. Objective This study assessed cost-effectiveness studies of novel pharmacological treatments (ezetimibe, proprotein convertase subtilisin/kexin type 9 [PCSK9] inhibitors, omega-3 polyunsaturated fatty acids [n-3 PUFAs], and the cardiovascular polypill) compared with standard care for the secondary prevention of CVD. Methods We searched seven databases and the reference list of selected literature reviews for eligible cost-effective analyses (CEA) published between January 2009 and January 2020 that evaluated the above novel treatments versus standard care. Two independent reviewers performed the screening and evaluation in accordance with the Consolidated Health Economic Evaluation Reporting Standards statement. Cost results were adapted to 2018 US dollars (US$) to facilitate comparisons between studies. Consideration of cost-effectiveness was based on the original study criteria. Results Thirty-two studies were included in this review, most of them adopting a healthcare perspective. Studies evaluating ezetimibe, PCSK9 inhibitors and n-3 PUFAs assessed their addition to standard care compared with standard care alone, while studies analysing the polypill evaluated the replacement of multiple monotherapies for a fixed-dose combination. Ten studies reported on ezetimibe, fifteen evaluated PCSK9 inhibitors, five focused on n-3 PUFAs and seven on the polypill. From a healthcare perspective, ezetimibe was cost effective in 62.5% of the studies (incremental cost-effectiveness ratios [ICERs]

show abstract

Section: Cost Adjustments Methodsmentioning

confidence: 99%

Section: Proprotein Convertase Subtilisin/kexin Type 9 (Pcsk9) Inhibimentioning

confidence: 99%

Section: Proprotein Convertase Subtilisin/kexin Type 9 (Pcsk9) Inhibimentioning

confidence: 99%

See 1 more Smart Citation

743 WITHDRAWN:Â Novel Treatment Strategies for Secondary Prevention of Cardiovascular Disease: A Systematic Review of Cost-Effectiveness

2020

Heart, Lung and Circulation

View full text Add to dashboard Cite

show abstract

“…Our study was in line with previous studies investigated the cost-effectiveness of ezetimibe combined with statin using different models in different clinical contexts. [35][36][37][38][39][40][41][42][43] de Labry Lima et al 35 that it is cost-effective to treat patients with high cardiovascular risk with ezetimibe plus atorvastatin than switching to rosuvastatin. In particular patients with acute coronary syndrome (ACS) 37,40 or chronic kidney disease (CKD), 41 the cost-effectiveness of the combined regimen of ezetimibe and moderate-dose statins may not be promising.…”

Section: Discussionmentioning

confidence: 99%

<p>Cost-Effectiveness Analysis of Ezetimibe as the Add-on Treatment to Moderate-Dose Rosuvastatin versus High-Dose Rosuvastatin in the Secondary Prevention of Cardiovascular Diseases in China: A Markov Model Analysis</p>

Yang

Zhou

et al. 2020

DDDT

View full text Add to dashboard Cite

Background: For patients with inadequate control of cholesterol using moderate-dose statins in the secondary prevention of cardiovascular diseases (CVD), either doubling the dose of statins or adding ezetimibe should be considered. The cost-effectiveness of them is unknown in the Chinese context. The aim of this study is to compare the cost and effectiveness of the two regimens, and estimate the incremental cost-effectiveness ratio (ICER).Methods: A Markov model of five health statuses were used to estimate long-term costs and quality-adjusted life-years (QALYs) of the two treatment regimens from the healthcare perspective. The effectiveness data used to calculate the transition probability was based on a previously published randomized trial. The utility data was gathered from literature and the costs were gathered from the electronic medical record system of West China Hospital in Chinese Yuan (CNY) in 2017 price. One-way sensitivity analysis and probabilistic sensitivity analysis were conducted. Results: The ICER for ezetimibe plus moderate-dose rosuvastatin was 47,102.99 CNY per QALY for 20 years simulation, which did not reach the threshold of per capita gross domestic product (GDP) of 59,660 CNY per QALY in 2017 in China. Non-CVD-related mortality and CVD-related mortality contributed most to the ICER. Conclusion: Adding ezetimibe to the moderate-dose statin in secondary prevention for CVD is cost-effective, compared with the high-dose statin in the Chinese context whose lowdensity lipoprotein cholesterol (LDL-c) was not inadequately controlled by moderate-dose statin alone.

show abstract

“…In an BIA analysis from Spain, with an average annual cost of patients receiving evolocumab of €11 134.78 and €393.83 for standard treatment (statins plus ezetimibe), the ICER was >€600 000 per avoided CV event for both assessed outcomes (first: CV death, MI, stroke and hospitalisation due to unstable angina or coronary revascularisation; second: includes the first three events). Authors claim that treatment with evolocumab is inefficient for patients suitable to receive this drug in the Spanish National Health System 26…”

Section: Discussionmentioning

confidence: 99%

Budget impact analysis of PCSK9 inhibitors costs from a community payers’ perspective in Apulia, Italy

2019

View full text Add to dashboard Cite

IntroductionDespite established clinical efficacy of PCSK9 inhibitors (PCSK9i) in reducing cardiovascular events, their cost still represents a big matter of debate. We therefore sought to estimate possible impact of PCSK9i therapy from a community taxpayers’ perspective with a budget impact analysis based on data coming from two randomised trials (FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk), ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab)).MethodsThe analysis focused on Apulia region, South-Eastern Italy (4 million inhabitants). Costs per cardiovascular event saved were calculated from randomised trials data and annually indexed per Apulia’s inhabitants.ResultsOn the base of actual cost in Apulia, individual costs per saved adverse event ranged from €0.12 to €0.78, with just €1 annually spent per Apulia’s inhabitant, 2–8.3 events could be avoided thanks to the use of PCSK9i.When considering high-risk subgroups (baseline cholesterol levels >100 mg/dL, multivessel coronary disease), the annual cost per Apulia’s inhabitant for one death avoided was more than halved to €0.19 and the cost for a saved major adverse cardiovascular event was €0.07. With €1 annually spent per Apulia’s inhabitant, 10.9–15 major adverse cardiovascular events and 5.3 deaths could be saved.ConclusionsWhen considered from a large taxpayers’ community perspective, relevant costs per cardiovascular event saved with PCSK9i may turn into very small individual costs per year. The selection of high-risk subgroups may further reduce individual costs.

show abstract

Cost-effectiveness and Budget Impact of Treatment with Evolocumab Versus Statins and Ezetimibe for Hypercholesterolemia in Spain

Cited by 8 publications

References 34 publications

743 WITHDRAWN:Â Novel Treatment Strategies for Secondary Prevention of Cardiovascular Disease: A Systematic Review of Cost-Effectiveness

743 WITHDRAWN:Â Novel Treatment Strategies for Secondary Prevention of Cardiovascular Disease: A Systematic Review of Cost-Effectiveness

<p>Cost-Effectiveness Analysis of Ezetimibe as the Add-on Treatment to Moderate-Dose Rosuvastatin versus High-Dose Rosuvastatin in the Secondary Prevention of Cardiovascular Diseases in China: A Markov Model Analysis</p>

Budget impact analysis of PCSK9 inhibitors costs from a community payers’ perspective in Apulia, Italy

Contact Info

Product

Resources

About