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Cost-effectiveness ...
Cost-effectiveness of proprotein convertase subtilisin/kexin type 9 inhibition with evolocumab in patients with a history of myocardial infarction in Sweden
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Landmesser, Ulf (author)
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- Lindgren, Peter (author)
- Karolinska Institutet
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- Hagström, Emil (author)
- Uppsala universitet,Kardiologi
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van Hout, Ben (author)
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Villa, Guillermo (author)
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Pemberton-Ross, Peter (author)
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Arellano, Jorge (author)
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- Svensson, Maria K. (author)
- Uppsala universitet,Njurmedicin,Medical Affairs, Amgen AB, Gustav III: s Boulevard 54, 169 74, Solna, Sweden.
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Sibartie, Mahendra (author)
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Fonarow, Gregg C (author)
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Svensson, ME (author)
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(creator_code:org_t)
- 2020-10-16
- 2022
- English.
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In: European Heart Journal - Quality of Care and Clinical Outcomes. - : Oxford University Press (OUP). - 2058-5225 .- 2058-1742. ; 8:1, s. 31-38
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Abstract
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- Aims: To assess the cost-effectiveness of proprotein convertase subtilisin/kexin type 9 inhibition with evolocumab added to standard-of-care lipid-lowering treatment [maximum tolerated dose (MTD) of statin and ezetimibe] in Swedish patients with a history of myocardial infarction (MI).Methods and results: Cost-effectiveness was evaluated using a Markov model based on Swedish observational data on cardiovascular event rates and efficacy from the FOURIER trial. Three risk profiles were considered: recent MI in the previous year; history of MI with a risk factor; and history of MI with a second event within 2 years. For each population, three minimum baseline low-density lipoprotein cholesterol (LDL-C) levels were considered: 2.5 mmol/L (≈100 mg/dL), based on the current reimbursement recommendation in Sweden; 1.8 mmol/L (≈70 mg/dL), based on 2016 ESC/EAS guidelines; and 1.4 mmol/L (≈55 mg/dL), or 1.0 mmol/L (≈40 mg/dL) for MI with a second event, based on 2019 ESC/EAS guidelines. Proprotein convertase subtilisin/kexin type 9 inhibition with evolocumab was associated with increased quality-adjusted life-years and costs vs. standard-of-care therapy. Incremental cost-effectiveness ratios (ICERs) were below SEK700 000 (∼€66 500), the generally accepted willingness-to-pay threshold in Sweden, for minimum LDL-C levels of 2.3 (recent MI), 1.7 (MI with a risk factor), and 1.7 mmol/L (MI with a second event). Sensitivity analyses demonstrated that base-case results were robust to changes in model parameters.Conclusion: Proprotein convertase subtilisin/kexin type 9 inhibition with evolocumab added to MTD of statin and ezetimibe may be considered cost-effective at its list price for minimum LDL-C levels of 1.7–2.3 mmol/L, depending on risk profile, with ICERs below the accepted willingness-to-pay threshold in Sweden.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Cost-effectiveness
- Evolocumab
- Low-density lipoprotein cholesterol
- Myocardial infarction
- PCSK9 inhibitors
- Statins
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Landmesser, Ulf
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Lindgren, Peter
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Hagström, Emil
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van Hout, Ben
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Villa, Guillermo
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Pemberton-Ross, ...
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show more...
-
Arellano, Jorge
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Svensson, Maria ...
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Sibartie, Mahend ...
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Fonarow, Gregg C
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Svensson, ME
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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European Heart J ...
- By the university
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Uppsala University
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Karolinska Institutet