Economic evaluation of ezetimibe treatment in combination with statin therapy in the United States

被引:13
|
作者
Davies, Glenn M. [1 ]
Vyas, Ami [2 ,3 ]
Baxter, Carl A. [4 ]
机构
[1] Merck & Co Inc, Kenilworth, NJ USA
[2] Rutgers State Univ, Sch Publ Hlth, Dept Epidemiol, Piscataway, NJ USA
[3] Univ Rhode Isl, Coll Pharm, Dept Pharm Practice, Kingston, RI 02881 USA
[4] MSD Ltd, Hoddesdon, England
关键词
Ezetimibe; statins; coronary heart disease; cerebrovascular disease; cost-effectiveness; HIGH-RISK PATIENTS; COST-EFFECTIVENESS; CARDIOVASCULAR-DISEASE; MYOCARDIAL-INFARCTION; PRIMARY PREVENTION; HEART-ASSOCIATION; CHOLESTEROL; ADHERENCE; EFFICACY; RECOMMENDATIONS;
D O I
10.1080/13696998.2017.1320559
中图分类号
F [经济];
学科分类号
02 ;
摘要
Aims: This study assessed the cost-effectiveness of ezetimibe with statin therapy vs statin monotherapy from a US payer perspective, assuming the impending patent expiration of ezetimibe. Methods: A Markov-like economic model consisting of 28 distinct health states was used. Model population data were obtained from US linked claims and electronic medical records, with inclusion criteria based on diagnostic guidelines. Inputs came from recent clinical trials, meta-analyses, and cost-effectiveness analyses. The base-case scenario was used to evaluate the cost-effectiveness of adding ezetimibe 10mg to statin in patients aged 35-74 years with a history of coronary heart disease (CHD) and/or stroke, and with low-density lipoprotein cholesterol (LDL-C) levels >= 70mg/dL over a lifetime horizon, assuming a 90% price reduction of ezetimibe after 1 year to take into account the impending patent expiration in the second quarter of 2017. Sub-group analyses included patients with LDL-C levels >= 100mg/dL and patients with diabetes with LDL-C levels >= 70mg/dL. Results: The lifetime discounted incremental cost-effectiveness ratio (ICER) for ezetimibe added to statin was $9,149 per quality-adjusted life year (QALY) for the base-case scenario. For patients with LDL-C levels >= 100mg/dL, the ICER was $839/QALY; for those with diabetes and LDL-C levels >= 70mg/dL, it was $560/QALY. One-way sensitivity analyses showed that the model was sensitive to changes in cost of ezetimibe, rate reduction of non-fatal CHD, and utility weight for non-fatal CHD in the base-case and sub-group analyses. Limitations: Indirect costs or treatment discontinuation estimation were not included. Conclusions: Compared with statin monotherapy, ezetimibe with statin therapy was cost-effective for secondary prevention of CHD and stroke and for primary prevention of these conditions in patients whose LDL-C levels are >= 100mg/dL and in patients with diabetes, taking into account a 90% cost reduction for ezetimibe.
引用
收藏
页码:723 / 731
页数:9
相关论文
共 50 条
  • [21] Comparison of the Efficacy of Ezetimibe Combination Therapy and High-Intensity Statin Monotherapy in Type 2 Diabetes
    Park, So Young
    Jun, Ji Eun
    Jeong, In-Kyung
    Ahn, Kyu Jeung
    Chung, Ho Yeon
    Hwang, You-Cheol
    JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2024, 109 (07) : 1883 - 1890
  • [22] Therapeutic practice patterns related to statin potency and ezetimibe/simvastatin combination therapies in lowering LDL-C in patients with high-risk cardiovascular disease
    Toth, Peter P.
    Foody, JoAnne M.
    Tomassini, Joanne E.
    Sajjan, Shiva G.
    Ramey, Dena R.
    Neff, David R.
    Tershakovec, Andrew M.
    Hu, Henry
    Tunceli, Kaan
    JOURNAL OF CLINICAL LIPIDOLOGY, 2014, 8 (01) : 107 - 116
  • [23] A Case Study of Single-Pill Combination Therapy: The Ezetimibe/Simvastatin Combination for Treatment of Hyperlipidemia
    Huang, Xianhai
    Chen, David Y. -K.
    CHEMMEDCHEM, 2012, 7 (11) : 1882 - 1894
  • [24] Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes
    Cannon, Christopher P.
    Blazing, Michael A.
    Giugliano, Robert P.
    McCagg, Amy
    White, Jennifer A.
    Theroux, Pierre
    Darius, Harald
    Lewis, Basil S.
    Ophuis, Ton Oude
    Jukema, J. Wouter
    De Ferrari, Gaetano M.
    Ruzyllo, Witold
    De Lucca, Paul
    Im, KyungAh
    Bohula, Erin A.
    Reist, Craig
    Wiviott, Stephen D.
    Tershakovec, Andrew M.
    Musliner, Thomas A.
    Braunwald, Eugene
    Califf, Robert M.
    NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (25) : 2387 - 2397
  • [25] The efficacy and safety of statin in combination with ezetimibe compared with double-dose statin in patients with high cardiovascular risk: A meta-analysis
    Zhu, Yunyun
    Hu, Haochang
    Yang, Jun
    Yao, Qi
    Xu, Hongyu
    Yu, Yushan
    Liu, Ting
    Lin, Shaoyi
    BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES, 2020, 20 (02) : 169 - 182
  • [26] Have We Learnt all from IMPROVE-IT? Part II. Subanalyses of the Effects of Ezetimibe Added to Statin Therapy on Selected Clinical and Laboratory Outcomes, Cost-Effectiveness, Guidelines, and Clinical Implications
    Fras, Zlatko
    Mikhailidis, Dimitri P.
    CURRENT VASCULAR PHARMACOLOGY, 2021, 19 (05) : 469 - 486
  • [27] Economic benefits of the Mediterranean-style diet consumption in Canada and the United States
    Abdullah, Mohammad M. H.
    Jones, Jason P. H.
    Jones, Peter J. H.
    FOOD & NUTRITION RESEARCH, 2015, 59
  • [28] The Effect of Ezetimibe/Statin Combination and High-Dose Statin Therapy on Thyroid Autoimmunity in Women with Hashimoto's Thyroiditis and Cardiovascular Disease: A Pilot Study
    Krysiak, R.
    Szkrobka, W.
    Okopien, B.
    EXPERIMENTAL AND CLINICAL ENDOCRINOLOGY & DIABETES, 2016, 124 (09) : 577 - 581
  • [29] Low persistence of simvastatin and ezetimibe fixed combination in the lipid lowering therapy
    Gabor, Simonyi
    Tamas, Ferenci
    ORVOSI HETILAP, 2015, 156 (04) : 141 - 145
  • [30] The effect of statin therapy in combination with ezetimibe on circulating C-reactive protein levels: a systematic review and meta-analysis of randomized controlled trials
    Arabi, Seyyed Mostafa
    Chambari, Mahla
    Malek-Ahmadi, Mahsa
    Bahrami, Leila Sadat
    Hadi, Vahid
    Rizzo, Manfredi
    Sahebkar, Amirhossein
    INFLAMMOPHARMACOLOGY, 2022, 30 (05) : 1597 - 1615