PharmacoEconomics & Outcomes News 792, p23 - 2 Dec 2017 PCSK9i therapy projected to have low budget impact in USA Add-on treatment with an PCSK9 inhibitor (PCSK9i; alirocumab or evolocumab) for further reduction of LDL cholesterol levels in statin -treated adults with heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease is projected to have a low budget impact in the USA, according to findings of a Sanofi/Regeneron-funded analysis published in PharmacoEconomics. A model was used to evaluate the budget impact of add-on alirocumab or evolocumab in 27 844 target patients with uncontrolled LDL cholesterol despite statin treatment, compared with statins alone, over a three- year time horizon in a hypothetical US healthcare plan with one million members. As a separate scenario, the budget impact of PCSK9i was also calculated from the perspective of commercial and Medicare Advantage health plans. Assumed total annual costs of lipid modifying therapy including PCSK9 inhibitor costs were ** $14 563.50. The estimated total healthcare budget impact during year 1, 2 and 3 was $3.62, $7.22 and $10.79 per target patient per month (PPPM), respectively, at up to 5% PCSK9i utilisation, and $15.81, $31.52 and $47.12, respectively, at 5%–10% utilisation. The estimated budget impact per member per month during year 1, 2 and 3 was only $0.10, $0.20 and $0.30, respectively, at up to 5% PCSK9i utilisation, and $0.44, $0.88 and $1.31, respectively, at 5%–10% utilisation. The introduction of PCSK9i would yield a net total healthcare budget increase of $1.21 million, $2.43 million and $3.66 million during years 1, 2 and 3, respectively ($7.30 million over 3 years). Increased utilisation of PCSK9i would result in 3-year cardiovascular event-related cost savings of $2.02 million. Assuming a PCSK9i utilisation rate of up to 5%, 3-year total healthcare costs were estimated to increase by $8.08 PPPM for a commercial health plan compared with the reference scenario, and by $6.26 PPPM for a Medicare Advantage health plan. Results were sensitive to the time horizon, the number of years to maximum PCSK9i utilisation, and PCSK9i costs. "These findings suggest that the PCSK9i alirocumab and evolocumab, at wholesale acquisition cost, are likely to have a smaller impact on US healthcare plans compared with prior estimates," said the authors. "If the manufacturers offer rebates and discounts to the list price, the budget impact would be lower than the results presented herein," they noted. * HMG-CoA reductase inhibitor ** 2017 US dollars Mallya UG, et al. Budget Impact Analysis of PCSK9 Inhibitors for the Management of Adult Patients with Heterozygous Familial Hypercholesterolemia or Clinical Atherosclerotic Cardiovascular Disease. PharmacoEconomics : 27 Nov 2017. Available from: URL: https://doi.org/10.1007/ s40273-017-0590-5 1173-5503/17/0792-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Dec 2017 No. 792
PharmacoEconomics & Outcomes News – Springer Journals
Published: Dec 2, 2017
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