The Cost-Effectiveness of Hyperlipidemia Medication in Low- and Middle-Income Countries: A Review

Husain, Muhammad Jami; Spencer, Garrison; Nugent, Rachel; Kostova, Deliana; Richter, Patricia

doi:10.5334/gh.1097

Cited by 10 publications

(10 citation statements)

References 48 publications

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“…Additionally, by comparing the costs and outcomes of high-intensity statin therapy to the expenses associated with managing cardiovascular events without statin therapy, the CEA can assist in identifying potential cost-saving opportunities. For patients with ACS in LMICs, these data can be utilized to guide the development of cost-effective treatment strategies and inform health policy decision makers [ 26 , 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients

Dewi,

Thavorncharoensap,

Rahajeng

2024

Egypt Heart J

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Background Post-hospitalized acute coronary syndrome (ACS) patients in Indonesia National Insurance does not pay for the use of high-intensity statin (HIS) for secondary prevention after ACS hospitalization. Moreover, a cost–utility analysis needs to be conducted to evaluate the cost-effectiveness of prescribing HIS and low-to-moderate-intensity statin (LMIS) per quality-adjusted life year (QALY). This study aimed to estimate the cost–utility of long-term HIS treatment in post-hospitalized ACS patients in Indonesia compared to current practice. Results This study compared the economic outcomes of long-term HIS and LMIS in Indonesian post-hospitalized ACS patients. A lifetime Markov model predicted ACS-related events, costs, and QALY from a payer perspective. A systematic review estimated treatment-specific event probabilities, post-event survival, health-related quality of life, and Indonesia medical-care expenses from published sources. This study conducted probabilistic sensitivity analysis (PSA) using 1000 independent Monte Carlo simulations and a series of one-way deterministic sensitivity analyses utilizing a tornado diagram. The economic evaluation model proved that intensive HIS treatment can increase per-patient QALYs and care expenditures compared to LMIS. The use of HIS among post-hospitalized ACS patients had ICER 31.843.492 IDR per QALY gained, below the Indonesia willingness-to-pay (WTP) for terminal disease and life-saving treatment. Conclusion From the Indonesia payer perspective, using HIS for post-hospitalized ACS patients in Indonesia is cost-effective at 31.843.492 IDR per QALY gained.

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Section: Discussionmentioning

confidence: 99%

Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients

Dewi,

Thavorncharoensap,

Rahajeng

2024

Egypt Heart J

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“…(HDL) cholesterol [54]. Is a major risk factor for cardiovascular disease (CVD) [55]. The etiology is the result of a combination of genes and environmental factors [56].…”

Section: Hyperlipidemiamentioning

confidence: 99%

Gut Microbiota and Metabolic Diseases

Tang¹,

Tang²

2022

JBM

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In this review, the characteristics of gut microbiota changes in 11 metabolic diseases, as well as the research progress on their interventions, are summarized. The gut microbiota contributes to metabolic diseases through intestinal mucosal dysfunction, chronic metabolic inflammatory response, gut brain axis imbalance, gene regulation, insulin resistance, and the action of its metabolites. The researches of cause effect relationship and mechanism are relatively few, need further study, expecting a breakthrough in the future to be a new path in the treatment of some metabolic diseases.

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“…The overall prevalence rates of TC ≥200 mg/dL and TC ≥240 mg/dL in adults over 20 years old were 42% and 17%, respectively. [ 5 ] The prevention and control of CVD risk factors, including hyperlipidemia, is considered a preliminary measure in primary or secondary prevention and should be a priority for the health-care system to reduce the burden of CVDs. [ 4 ] The results of studies show that the management of hyperlipidemia reduces mortality and CVD occurrences by 30%.…”

Section: Introductionmentioning

confidence: 99%

“…[ 4 ] The results of studies show that the management of hyperlipidemia reduces mortality and CVD occurrences by 30%. [ 3 4 5 6 7 8 ] The value of reducing TC and LDL-C in the primary and secondary prevention of CVD is evident based on the results of several epidemiological studies. [ 3 ]…”

Section: Introductionmentioning

confidence: 99%

First Iranian guidelines for the diagnosis, management, and treatment of hyperlipidemia in adults

Kholenjani,

Shahidi,

Vaseghi

et al. 2024

Journal of Research in Medical Sciences

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This guideline is the first Iranian guideline developed for the diagnosis, management, and treatment of hyperlipidemia in adults. The members of the guideline developing group (GDG) selected 9 relevant clinical questions and provided recommendations or suggestions to answer them based on the latest scientific evidence. Recommendations include the low-density lipoprotein cholesterol (LDL-C) threshold for starting drug treatment in adults lacking comorbidities was determined to be over 190 mg/dL and the triglyceride (TG) threshold had to be >500 mg/dl. In addition to perform fasting lipid profile tests at the beginning and continuation of treatment, while it was suggested to perform cardiovascular diseases (CVDs) risk assessment using valid Iranian models. Some recommendations were also provided on lifestyle modification as the first therapeutic intervention. Statins were recommended as the first line of drug treatment to reduce LDL-C, and if its level was high despite the maximum allowed or maximum tolerated drug treatment, combined treatment with ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors, or bile acid sequestrants was suggested. In adults with hypertriglyceridemia, pharmacotherapy with statin or fibrate was recommended. The target of drug therapy in adults with increased LDL-C without comorbidities and risk factors was considered an LDL-C level of <130 mg/dl, and in adults with increased TG without comorbidities and risk factors, TG levels of <200 mg/dl. In this guideline, specific recommendations and suggestions were provided for the subgroups of the general population, such as those with CVD, stroke, diabetes, chronic kidney disease, elderly, and women.

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The Cost-Effectiveness of Hyperlipidemia Medication in Low- and Middle-Income Countries: A Review

Cited by 10 publications

References 48 publications

Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients

Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients

Gut Microbiota and Metabolic Diseases

First Iranian guidelines for the diagnosis, management, and treatment of hyperlipidemia in adults

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