Frequency of High-Risk Patients Not Receiving High-Potency Statin (from a Large Managed Care Database)

Rodríguez, Fátima; Olufade, Temitope; Heithoff, Kim A.; Frıedman, Howard S.; Navaratnam, Prakash; Foody, JoAnne M.

doi:10.1016/j.amjcard.2014.10.021

Cited by 22 publications

(17 citation statements)

References 18 publications

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“…The inclusion criteria were based not only on cholesterol levels (>70 mg/dL despite treatment with statins) but on a high cardiovascular risk associated with the presence of a documented coronary disease or a coronary artery disease equivalent (defined as peripheral arterial disease, prior ischaemic stroke, moderate chronic kidney disease with GFR 30–60 mL/min/1.73 m 2 body surface area), or diabetes mellitus plus two or more additional risk factors (hypertension; ankle–brachial index ≤0.90; microalbuminuria, macroalbuminuria, or urine dipstick >2+ proteins; retinopathy; or a family history of premature coronary disease) 84 . In the USA, 47.5% of high-risk adult dyslipidaemics are currently not on statins and just 25% of high-risk patients receive high-intensity statins 233 . This rate is even lower in Europe, where a high-intensity statin is prescribed in less than 10% of all high-risk patients 234 .…”

Section: Eligibility For Treatment With Pcsk9 Inhibitorsmentioning

confidence: 99%

ANMCO/ISS/AMD/ANCE/ARCA/FADOI/GICR-IACPR/SICI-GISE/SIBioC/SIC/SICOA/SID/SIF/SIMEU/SIMG/SIMI/SISA Joint Consensus Document on cholesterol and cardiovascular risk: diagnostic–therapeutic pathway in Italy

Gulizia

Colivicchi

Ricciardi³

et al. 2017

European Heart Journal Supplements

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Atherosclerotic cardiovascular disease still represents the leading cause of death in Western countries. A wealth of scientific evidence demonstrates that increased blood cholesterol levels have a major impact on the outbreak and progression of atherosclerotic plaques. Moreover, several cholesterol-lowering pharmacological agents, including statins and ezetimibe, have proved effective in improving clinical outcomes. This document focuses on the clinical management of hypercholesterolaemia and has been conceived by 16 Italian medical associations with the support of the Italian National Institute of Health. The authors discuss in detail the role of hypercholesterolaemia in the genesis of atherosclerotic cardiovascular disease. In addition, the implications for high cholesterol levels in the definition of the individual cardiovascular risk profile have been carefully analysed, while all available therapeutic options for blood cholesterol reduction and cardiovascular risk mitigation have been explored. Finally, this document outlines the diagnostic and therapeutic pathways for the clinical management of patients with hypercholesterolaemia.

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Section: Eligibility For Treatment With Pcsk9 Inhibitorsmentioning

confidence: 99%

ANMCO/ISS/AMD/ANCE/ARCA/FADOI/GICR-IACPR/SICI-GISE/SIBioC/SIC/SICOA/SID/SIF/SIMEU/SIMG/SIMI/SISA Joint Consensus Document on cholesterol and cardiovascular risk: diagnostic–therapeutic pathway in Italy

Gulizia

Colivicchi

Ricciardi³

et al. 2017

European Heart Journal Supplements

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“…Patients with PGT (test group) and without (control group) were identified in a stepwise fashion (Figure ). Individuals with MAPD, Medicaid, or commercial coverage and ≥1 atherosclerotic cardiovascular disease (ASCVD)‐related diagnosis were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) diagnosis codes (Table ) in any position on any medical claim during the study period …”

Section: Methodsmentioning

confidence: 99%

“…Modification (ICD-9-CM) diagnosis codes (Table S1) in any position on any medical claim during the study period. 23 Individuals with ≥1 paid medical claim for CV-related PGT (Table 1) were included in the test group. CV-related pharmacogenomic tests were selected based upon literature published in nationally peer-reviewed journals, utilisation, and having a defined Current Procedural Terminology (CPT) code.…”

Section: International Classification Of Diseases Ninth Revision CLmentioning

confidence: 99%

The impact of real-world cardiovascular-related pharmacogenetic testing in an insured population

et al. 2018

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“…Despite the use of statins, previous research has shown that a substantial proportion of treated high-risk patients fail to achieve target LDL-C levels. (10, 11) Moreover, statin intolerance is a common concern in clinical practice, with wide variation of individual lipid-lowering and risk reduction. (12–15) A substantial proportion of patients not meeting conventional LDL-C goals—more than 73 million U.S. adults (32%) experience elevated LDL-C(16)—suggests substantial benefits in reducing the burden of hypercholesterolemia.…”

Section: Introductionmentioning

confidence: 99%

PCSK9 Inhibitors Show Value for Patients and the US Health Care System

2017

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OBJECTIVES Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors were approved by the U.S. Food and Drug Administration (FDA) as cholesterol-lowering therapies for patients with familial hypercholesterolemia or atherosclerotic cardiovascular disease. This study estimates the long-term health and economic value of PCSK9 inhibitors for older Americans (aged 51 and older). METHODS We conducted simulations using the Future Elderly Model (FEM), an established dynamic microsimulation model, to project the lifetime outcomes for the U.S. population aged 51 or older. Health effects estimates and confidence intervals from published meta-analysis studies were used to project changes in life expectancy, quality-adjusted life-years, and lifetime medical spending resulting from use of PCSK9 inhibitors. We considered two treatment scenarios: 1) current FDA eligibility; and 2) an extended eligibility scenario which includes patients with no pre-existing cardiovascular disease (CVD) but at high-risk. We assumed the price of PCSK9 inhibitors was discounted by 35% in the first 12 years and by 57% thereafter, with gradual uptake of the drug in eligible populations. RESULTS Utilization of PCSK9 inhibitors by individuals covered by current FDA approval would extend life-expectancy at age 51 by an estimated 1.1 years and would yield a lifetime net value of $5,800 per person. If utilization were extended to those at high-risk for CVD, PCSK9 inhibitors would generate a lifetime net benefit of $14,100 per person. CONCLUSION Expanded access to PCSK9 inhibitors would offer positive long-term net value for patients and the U.S. healthcare system at the current discounted prices.

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Frequency of High-Risk Patients Not Receiving High-Potency Statin (from a Large Managed Care Database)

Cited by 22 publications

References 18 publications

ANMCO/ISS/AMD/ANCE/ARCA/FADOI/GICR-IACPR/SICI-GISE/SIBioC/SIC/SICOA/SID/SIF/SIMEU/SIMG/SIMI/SISA Joint Consensus Document on cholesterol and cardiovascular risk: diagnostic–therapeutic pathway in Italy

ANMCO/ISS/AMD/ANCE/ARCA/FADOI/GICR-IACPR/SICI-GISE/SIBioC/SIC/SICOA/SID/SIF/SIMEU/SIMG/SIMI/SISA Joint Consensus Document on cholesterol and cardiovascular risk: diagnostic–therapeutic pathway in Italy

The impact of real-world cardiovascular-related pharmacogenetic testing in an insured population

PCSK9 Inhibitors Show Value for Patients and the US Health Care System

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