Cost-Effectiveness of Simvastatin Plus Ezetimibe for Cardiovascular Prevention in Patients With a History of Acute Coronary Syndrome: Analysis of Results of the IMPROVE-IT Trial

Almalki, Ziyad S.; Guo, Jeff J.; Alahmari, Abdullah K.; Alotaibi, Nawaf M.; Thaibah, Hilal

doi:10.1016/j.hlc.2017.05.139

Cited by 13 publications

(56 citation statements)

References 41 publications

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“…The general characteristics of the included articles organised by treatment strategies are summarised in Table 1. Of the selected studies, ten evaluated ezetimibe [12,13,32,33,35,36,[42][43][44][45], 15 PCSK9 inhibitors [12, 26, 28-30, 33, 37-39, 43-48], five n-3 PUFAs [31,40,[49][50][51], and seven the polypill [27,34,41,[52][53][54][55]. Four out of the 15 studies focusing on PCSK9 inhibitors also reported the ICERs of ezetimibe versus statins, but considering ezetimibe as a comparator [12,33,43,44], and those results have also been included and reported in this review.…”

Section: General Characteristics Of the Included Studiesmentioning

confidence: 99%

743 WITHDRAWN:Â Novel Treatment Strategies for Secondary Prevention of Cardiovascular Disease: A Systematic Review of Cost-Effectiveness

2020

Heart, Lung and Circulation

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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]

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Section: General Characteristics Of the Included Studiesmentioning

confidence: 99%

743 WITHDRAWN:Â Novel Treatment Strategies for Secondary Prevention of Cardiovascular Disease: A Systematic Review of Cost-Effectiveness

2020

Heart, Lung and Circulation

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“…However, in a 5-10 year follow-up model, ezetimibe combined with statin therapy is not a cost-effective alternative, but when the follow-up period is extended to a lifetime, combination therapy becomes a cost-effective treatment. [22] In a Chinese study, LDL-C<1.8 mmol/l was 26.2% and 28.2% in patients using high-intensity and moderate-intensity statins, respectively. [23] Another study showed that 63.8% of acute coronary syndrome patients had LDL-C level greater than 1.80 mmol/L, and 71.5% received highintensity statin therapy.…”

Section: Discussionmentioning

confidence: 97%

“…Systematic analysis of the Global Burden of Disease Study in 2017 showed that cardiovascular disease remained the leading cause of death worldwide, with 8.9 million deaths from ischemic cardiomyopathy, a 22.3% increase over 2007. [1] China is the world's most populous country, with 290 million people suffering from cardiovascular disease and 5 million patients with coronary artery disease(CAD).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Changes in Population LDL-C Levels on LDL-C Control in Patients After PCI in China: A Retrospective Cohort Study

Liu

Zhou

2020

Preprint

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BANKGROUND: Mortality from coronary artery disease continues to rise, and secondary prevention and treatment are particularly important. OBJECTIVE: The objective of this study is to evaluate low-density lipoprotein cholesterol (LDL-C) levels in patients after percutaneous coronary intervention (PCI), to describe how treatment outcomes for individual patients changed over time and to examine the potential impact of lipid control rates through population LDL-C levels changes.METHODS: This retrospective study was conducted in patients who underwent PCI between July 2017 and June 2019. The main results included LDL-C levels after PCI. To assess the outcome of prevention, three separate measures of LDL-C were considered: baseline, first follow-up, and final follow-up, and LDL-C control rates were analyzed according to different guidelines. we examine the impact of 0.1mmol/l decreases or increases in population LDL-C levels on LDL-C control.RESULTS: Data were analyzed for 423 patients (mean age, 62 ±10 years), and the baseline LDL-C level was 3.11 ± 0.99 mmol/l. 51.5% of the patients achieved the Chinese Lipids Guidelines treatment goal, 22% and 11.6% of the patients achieved the 2016 ESC Lipids Guidelines and 2019 ESC Lipids Guidelines treatment goal at the final follow-up period respectively. LDL-C levels fluctuated during the follow-up period, and the long-term maintenance results could not be guaranteed after PCI. Population LDL-C levels changes in lifestyle could have a very large impact on LDL-C control in China.CONCLUSION: LDL-C control with statins is not ideal in patients after PCI, which is far from the requirements of the latest guidelines. Although clinicians understand the lipid-lowering effect of statins, they should not give up active lifestyle changes, and should strengthen the comprehensive management of blood lipid control.

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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 Simvastatin Plus Ezetimibe for Cardiovascular Prevention in Patients With a History of Acute Coronary Syndrome: Analysis of Results of the IMPROVE-IT Trial

Cited by 13 publications

References 41 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

The Impact of Changes in Population LDL-C Levels on LDL-C Control in Patients After PCI in China: A Retrospective Cohort Study

<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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Cost-Effectiveness of Simvastatin Plus Ezetimibe for Cardiovascular Prevention in Patients With a History of Acute Coronary Syndrome: Analysis of Results of the IMPROVE-IT Trial

Cited by 13 publications

References 41 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

The Impact of Changes in Population LDL-C Levels on LDL-C Control in Patients After PCI&nbsp;in China: A Retrospective Cohort Study

<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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The Impact of Changes in Population LDL-C Levels on LDL-C Control in Patients After PCI in China: A Retrospective Cohort Study