In patients with familial hypercholesterolemia, atherosclerotic cardiovascular disease
WEDNESDAY, Aug. 17, 2016 (HealthDay News) — For patients with familial hypercholesterolemia (FH) or atherosclerotic cardiovascular disease (ASCVD), proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor use is not cost-effective, according to a study published in the Aug. 16 issue of the Journal of the American Medical Association.
Dhruv S. Kazi, M.D., from the University of California in San Francisco, and colleagues estimated the cost-effectiveness of PCSK9 inhibitors and their potential effect on U.S. health care spending in a simulation model of U.S. adults aged 35 to 94 years.
The researchers found that in heterozygous FH, adding PCSK9 inhibitors to statins was estimated to prevent 316,300 major adverse cardiovascular events (MACE) at a cost of $503,000 per quality-adjusted life year (QALY) gained, compared with adding ezetimibe to statins. In ASCVD, 4.3 million MACE were prevented at a cost of $414,000 for adding PCSK9 inhibitors to statins versus adding ezetimibe. For PCSK9 inhibitors to be cost-effective at less than $100,000 per QALY, annual drug costs would need to be reduced to $4,536 per patient or less. Over five years, PCSK9 inhibitor use in all eligible patients would reduce cardiovascular care costs by $29 billion, but drug costs would increase by an estimated $592 billion. Initiating statins in all statin-tolerant individuals within these high-risk populations was estimated to save $12 billion.
“Assuming 2015 prices, PCSK9 inhibitor use in patients with heterozygous FH or ASCVD did not meet generally acceptable incremental cost-effectiveness thresholds and was estimated to increase U.S. health care costs substantially,” the authors write.
Several authors disclosed financial ties to the biopharmaceutical industry.
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