Cost–effectiveness of adding ezetimibe to atorvastatin vs switching to rosuvastatin therapy in Portugal

Laires, PA; Ejzykowicz, Flavia; Hsu, Tun-Ying; Ambegaonkar, Baishali; Davies, Glenn

doi:10.3111/13696998.2015.1031794

Cited by 12 publications

(31 citation statements)

References 19 publications

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“…Moreover, Laires et al found that prescribing ezetimibe to high cardiovascular risk patients being treated with atorvastatin instead of switching them to rosuvastatin is projected to be a cost-effective use of resources [36]. It is worth mentioning that cardiovascular benefit of administration of atorvastatin/ ezetimibe is mainly attributed to atorvastatin.…”

Section: Clinical Human Studiesmentioning

confidence: 95%

Evaluating the safety of Liptruzet (ezetimibe and atorvastatin): what are the potential benefits beyond low-density lipoprotein cholesterol-lowering effect?

Husain

Hassan

Elmadhoun

et al. 2015

Expert Opinion on Drug Safety

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The combination of (eze/ator) is proven to be effective in lowering LDL-c. It is not only a safe and effective treatment of hyperlipidemia, but it also reduces inflammatory markers and atherosclerosis. It is not yet clear, however, whether the combination therapy can decrease the risk of diabetes associated with statin administration. Insulin sensitivity is improved by the single administration of ezetimibe, a finding that is documented by several clinical and animal studies. More specifically, ezetimibe has been shown to decrease insulin resistance associated with nonalcoholic fatty liver disease (NAFLD). The effects of combination therapy that have to be explored in future research and clinical trials include whether this combination can be used in the treatment of NAFLD, cholesterol gallstones and portal hypertension.

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Section: Clinical Human Studiesmentioning

confidence: 95%

Evaluating the safety of Liptruzet (ezetimibe and atorvastatin): what are the potential benefits beyond low-density lipoprotein cholesterol-lowering effect?

Husain

Hassan

Elmadhoun

et al. 2015

Expert Opinion on Drug Safety

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“…General Characteristics of the Included Studies: We retrieved and included twenty-two potentially relevant articles 20,[26][27][28][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] for systematic review, of which 21 studies were eligible for meta-analysis 20, 26-28, 44-46, 48-61 (Figure 1). One study from the UK, Ara et al 47 , was not included for meta-analysis due to incomplete data.…”

Section: Resultsmentioning

confidence: 99%

Cost-effectiveness of Ezetimibe plus statin lipid-lowering therapy: A systematic review and meta-analysis of cost-utility studies

Sasidharan

Jagadeesh

et al. 2022

Preprint

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IntroductionIn addition to statin therapy, Ezetimibe, a non-statin lipid-modifying agent, is increasingly used to reduce low-density lipoprotein cholesterol and atherosclerotic cardiovascular disease risk. Literature suggests the clinical effectiveness of Ezetimibe plus statin (EPS) therapy; however, primary evidence on its economic effectiveness is inconsistent. Hence we pooled incremental net benefit to synthesise the cost-effectiveness of EPS therapy.MethodsWe identified economic evaluation studies reporting outcomes of EPS therapy compared with other lipid-lowering therapeutic agents or placebo by searching PubMed, Embase, Scopus, and Tufts Cost-Effective Analysis registry. Using random-effects meta-analysis, we pooled Incremental Net Benefit (INB) in the US $ with a 95% confidence interval (CI). We used the modified economic evaluations bias checklist and GRADE quality assessment for quality appraisal. The review was apriori registered with PROSPERO, CRD42021248531.ResultsThe pooled INB from twenty-one eligible studies showed that EPS therapy was significantly cost-effective compared to other lipid-lowering therapeutic agents or placebo. The pooled INB (95% CI) was $4,274 (621 to 7,927), but there was considerable heterogeneity (I2=84.21). On subgroup analysis EPS therapy is significantly cost-effective in high-income countries [$4,356 (621 to 8,092)], for primary prevention [$4,814 (2,523 to 7,106)], and for payers’ perspective [$3,255 (571 to 5,939)], and from lifetime horizon [$4,571 (746 to 8,395)].ConclusionEPS therapy is cost-effective compared to other lipid-lowering therapeutic agents or placebo in high-income countries and for primary prevention. However, there is a dearth of evidence from lower-middle-income countries and the societal perspective.

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“…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

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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.

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Cost–effectiveness of adding ezetimibe to atorvastatin vs switching to rosuvastatin therapy in Portugal

Abstract: From the perspective of the National Health Service, prescribing ezetimibe to high cardiovascular risk patients being treated with atorvastatin vs switching them to rosuvastatin is projected to be a cost-effective use of resources in Portugal.

Cited by 12 publications

References 19 publications

Evaluating the safety of Liptruzet (ezetimibe and atorvastatin): what are the potential benefits beyond low-density lipoprotein cholesterol-lowering effect?

Evaluating the safety of Liptruzet (ezetimibe and atorvastatin): what are the potential benefits beyond low-density lipoprotein cholesterol-lowering effect?

Cost-effectiveness of Ezetimibe plus statin lipid-lowering therapy: A systematic review and meta-analysis of cost-utility studies

<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>

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