Comparative effectiveness of lipid-lowering treatments to reduce cardiovascular disease.

Abstract

INTRODUCTION:

The proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor is a new treatment option for patients with hypercholesterolemia. The objective of this study was to systematically review the cost-effectiveness of lipid-lowering agents.

AREAS COVERED:

Based on Pubmed, Embase, and Cochrane Database of Systematic Reviews, we identified 29 relevant articles. Studies found statins were cost-effective compared with placebo or no treatment in general. Atorvastatin was reported to be cost-effective against simvastatin. In most cases, rosuvastatin was more cost-effective than atorvastatin or simvastatin. Additionally, ezetimibe was considered to be cost-effective compared with no treatment for statin intolerant patients. For patients not meeting treatment goals with their statins, switching to ezetimibe plus simvastatin was consistently reported cost-effective. The cost-effectiveness of ezetimibe plus a hybrid of a statin varied by the source of clinical data and cost of ezetimibe. Finally, the cost-effectiveness of PCSK9 inhibitor plus a statin against statin monotherapy was uncertain. The PCSK9 inhibitor plus a stain was cost-ineffective compared with ezetimibe plus a statin.

EXPERT COMMENTARY:

Drug costs and treatment efficacy were the key drivers of the cost-effectiveness results in prior analyses. Future evaluations are warranted to reflect the decreasing drug prices and the long-term treatment effects of PCSK9 inhibitors.

• Authors: Dong-Churl Suh, Scott K Griggs, Emmett R Henderson, Seung-Mi Lee, Taehwan Park
• Journal: Expert review of pharmacoeconomics & outcomes research (Expert Rev Pharmacoecon Outcomes Res) Vol. 18 Issue 1 Pg. 51-69 (02 2018) ISSN: 1744-8379 [Electronic] England
• PMID: 29148854 (Publication Type: Comparative Study, Journal Article, Review)

Chemical References

• Anticholesteremic Agents
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• PCSK9 Inhibitors
• PCSK9 protein, human

Topics

• Anticholesteremic Agents (administration & dosage, economics, therapeutic use)
• Cardiovascular Diseases (economics, prevention & control)
• Cost-Benefit Analysis
• Drug Costs
• Drug Therapy, Combination
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage, economics, therapeutic use)
• Hypercholesterolemia (complications, drug therapy, economics)
• PCSK9 Inhibitors
• Treatment Outcome