PharmacoEconomics & Outcomes News 804, p25 - 2 Jun 2018 PCSK9 inhibitor therapy does not appear to be cost effective at current prices, according to findings of a review published in PharmacoEconomics. Embase and Medline were searched up to November 2017 for full economic studies evaluating the cost effectiveness of PCSK9 inhibitors (evolocumab and/ or alirocumab) for reducing LDL cholesterol levels and cardiovascular risk compared with statins (HMG-CoA reductase inhibitors) and/or ezetimibe. Ten studies met the selection criteria: eight from the US, one from Norway and one from Spain. The Spanish study and two US studies were Amgen-funded. Cost effectiveness was assessed over a lifetime time horizon in all studies. Five studies considered a healthcare system perspective. Other perspectives were health system and private payer (2 studies), payer (1), and societal (1). All studies were published between 2015 and 2017. In nine of the studies, estimated incremental cost- effectiveness ratios (ICERs) were above willingness-to- pay (WTP) thresholds. ICERs in the US ranged from $141 699 to $1 336 221 (2015–2017 values) per QALY gained. The exception was the study in Spain, which concluded that evolocumab was cost effective compared with statins in patients with familial hypercholesterolaemia (most of whom had established atherosclerotic cardiovascular disease), with an ICER of €30 893 (2017 values) per QALY gained. However, for secondary prevention in patients without familial hypercholesterolaemia, the ICER was €45 340 per QALY gained, which exceeded the WTP threshold in Spain (€45 000 per QALY gained). It was estimated that the prices of PCSK9 inhibitors would need to be reduced by 33%–95% to achieve cost effectiveness. "The cost effectiveness of PCSK9 inhibitors remains uncertain because only one large randomized clinical trial has reported results . . . Still, most of the studies analysed here conclude that PCSK9 inhibitors are not cost effective for most patient groups, given a threshold in the order of US$100,000 per QALY," concluded the authors. "All analysis results included in this review are highly sensitive to changes in price, such that significant price breaks lead to major reductions in ICERs and increases in likelihood of cost effectiveness. Price breaks in the order of 50–70% were necessary in most analyses for PCSK9 inhibitors to be considered cost effective at the stated WTP levels," they said. Korman MJ, et al. Are PCSK9 Inhibitors Cost Effective? PharmacoEconomics : 18 May 2018. Available from: URL: http://doi.org/10.1007/ s40273-018-0671-0 803322883 1173-5503/18/0804-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Jun 2018 No. 804
PharmacoEconomics & Outcomes News – Springer Journals
Published: Jun 2, 2018
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera