Pcv50 Real-World Economic Outcomes Comparison Between Thermocool Smarttouch® Sf Catheter and Thermocool Smarttouch® Catheter Among Patients With Atrial Fibrillation Undergoing Ablation in an Outpatient Setting: Results From Multi-Hospital Database Analysis

Abstract

Objectives: Nowadays, it is clear that correcting elevated LDL cholesterol (LDL-C) is an effective way to reduce CV event risk. This study assessed the cost-effectiveness of Alirocumab as add-on lipid-lowering therapy in high CV risk groups from the perspective of National Health Insurance in Taiwan. Methods: A Markov model, incorporating the disease progression of patients in terms of LDL-C level change, incidence of CV event and death, was used. Adult hyperlipidemia patients with high CV risk were included in the study. Intervention was the treatment using Alirocumab with high intensity statin as background therapy and compared to high intensity statin plus ezetimibe. Primary outcomes were direct medical cost, life-year, qualityadjusted life years (QALY), and incremental cost-effectiveness ratio (ICERs). To conduct simulation, we first set the cohort characteristics, including initial age, proportion of male, prevalence of diabetes and baseline LDL-C value based on the UK THIN data. Data related to treatment efficacy of statin, ezetimibe and Alirocumab, incidence of CV events, reduction of LDL-C level and health-related quality-of-life status were obtained from the ODYSSEY trial and published studies. The mortality of non-CV death was obtained the Taiwan's Death Registry data. Drug costs, CV event costs and CV death cost were obtained from Taiwan's National Health Insurance Claims data. Results: When compared to ezetimibe, hyperlipidemia patients with high CV risk received Alirocumab as add-on lipid lowering therapy gained 1.5 QALY at an additional cost of US$81,281.9, yielding an ICER of US$53,938.7 per QALY gained. Probabilistic senstivity analyses showed that when using 3 times of the GDP per capita as the threshold, the probability of Alirocumab being cost-effective was 74%. Conclusions: Using Alirocumab as an add-on treatment of hyperlipidemia.