Cost-Effectiveness of Alirocumab in Patients With Acute Coronary Syndromes
| Autor: | Deepak L. Bhatt, Andrew H. Briggs, Shelby D. Reed, Lieven Annemans, Michael Szarek, Vera A. Bittner, Rafael Diaz, Shaun G. Goodman, Robert A. Harrington, Keiko Higuchi, Florence Joulain, J. Wouter Jukema, Qian H. Li, Kenneth W. Mahaffey, Robert J. Sanchez, Matthew T. Roe, Renato D. Lopes, Harvey D. White, Andreas M. Zeiher, Gregory G. Schwartz, Ph. Gabriel Steg, Pierluigi Tricoci, Jay M. Edelberg, Corinne Hanotin, Guillaume Lecorps, Angèle Moryusef, Robert Pordy, William J. Sasiela, Jean-François Tamby |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome Apolipoprotein B Cost effectiveness Population 030204 cardiovascular system & hematology Placebo 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine 030212 general & internal medicine education Alirocumab education.field_of_study biology business.industry Cholesterol medicine.disease chemistry biology.protein lipids (amino acids peptides and proteins) Cardiology and Cardiovascular Medicine business Lipoprotein |
| Zdroj: | Journal of the American College of Cardiology. 75:2297-2308 |
| ISSN: | 0735-1097 0166-3402 |
| Popis: | Background Cholesterol reduction with proprotein convertase subtilisin-kexin type 9 inhibitors reduces ischemic events; however, the cost-effectiveness in statin-treated patients with recent acute coronary syndrome remains uncertain. Objectives This study sought to determine whether further cholesterol reduction with alirocumab would be cost-effective in patients with a recent acute coronary syndrome on optimal statin therapy. Methods A cost-effectiveness model leveraging patient-level data from ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was developed to estimate costs and outcomes over a lifetime horizon. Patients (n = 18,924) had a recent acute coronary syndrome and were on high-intensity or maximum-tolerated statin therapy, with a baseline low-density lipoprotein cholesterol (LDL-C) level ≥70 mg/dl, non–high-density lipoprotein cholesterol ≥100 mg/dl, or apolipoprotein B ≥80 mg/l. Alirocumab 75 mg or placebo was administered subcutaneously every 2 weeks. Alirocumab was blindly titrated to 150 mg if LDL-C remained ≥50 mg/dl or switched to placebo if 2 consecutive LDL-C levels were Results Across the overall population recruited to the ODYSSEY OUTCOMES trial, using an annual treatment cost of US$5,850, the mean overall incremental cost-effectiveness ratio was US$92,200 per QALY (base case). The cost was US$41,800 per QALY in patients with baseline LDL-C ≥100 mg/dl, whereas in those with LDL-C Conclusions In patients with a recent acute coronary syndrome on optimal statin therapy, alirocumab improves cardiovascular outcomes at costs considered intermediate value, with good value in patients with baseline LDL-C ≥100 mg/dl but less economic value with LDL-C NCT01663402 ) |
| Databáze: | OpenAIRE |
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