Cost-effectiveness of PCSK9 Inhibitor Therapy in Patients With Heterozygous Familial Hypercholesterolemia or Atherosclerotic Cardiovascular Disease

Estimated burden of cardiovascular disease and value-based price range for evolocumab in a high-risk, secondary-prevention population in the US payer context

“…The present analysis and that of Jena et al 36 used CV event rates derived from large realworld databases. For example, the rates of MI-and CV-related death per 100 patient-years in an ASCVD population were, respectively, 0.99 and 0.88 over 5 years in the report by Kazi et al 37 , and 2.8 and 2.4 over 7 years in the report by Jena et al 36 . The use of data from routine clinical practice (as done in this analysis) could help capture the real-world CV burden, which is an important input to the cost-effectiveness analysis.…”

“…The analysis by Jena et al 36 found that the social value of PCSK9 inhibitors would range from $3.4 trillion to $5.1 trillion (1.9-2.8 million deaths averted) or $12,000 to $17,000 per patient-year of treatment, which is largely aligned with the present value-based price range analysis. In contrast, Kazi et al 37 concluded that the current annual cost of PCSK9 inhibitors did not provide net monetary benefit in the US context and was not at value-based price ($6,904) assuming a WTPT of $150,000 per QALY gained. One notable difference among the three analyses is the baseline CV event rates.…”

“…One notable difference among the three analyses is the baseline CV event rates. Kazi et al 37 used rates that are comparable with rates observed in statin trials. The present analysis and that of Jena et al 36 used CV event rates derived from large realworld databases.…”

“…In addition to the published evolocumab-specific costeffectiveness model, there are two other recent publications that estimate the value of PCSK9 inhibitors in the US context 36,37 . The analysis by Jena et al 36 found that the social value of PCSK9 inhibitors would range from $3.4 trillion to $5.1 trillion (1.9-2.8 million deaths averted) or $12,000 to $17,000 per patient-year of treatment, which is largely aligned with the present value-based price range analysis.…”

Advances in dyslipidemia management for prevention of atherosclerosis: PCSK9 monoclonal antibody therapy and beyond

“…It has been recently estimated that annual drug costs per patient would need to be reduced to $4,536 to be cost-effective at the accepted <$100,000 per quality adjusted life year (QALY) (38). Broader indications for PCSK9 mAb therapy may be possible once further data become available in certain patient subgroups, cost-effectiveness is better documented, and most importantly, an improvement in clinical outcomes has been demonstrated.…”