Please use this identifier to cite or link to this item: https://ir.swu.ac.th/jspui/handle/123456789/12295
ชื่อเรื่อง: Cost-Effectiveness Analysis of Non-Statin Lipid-Modifying Agents for Secondary Cardiovascular Disease Prevention Among Statin-Treated Patients in Thailand
ผู้แต่ง: Kongpakwattana K.
Ademi Z.
Chaiyasothi T.
Nathisuwan S.
Zomer E.
Liew D.
Chaiyakunapruk N.
Keywords: ezetimibe
hydroxymethylglutaryl coenzyme A reductase inhibitor
proprotein convertase 9 inhibitor
serine proteinase inhibitor
unclassified drug
ezetimibe
hydroxymethylglutaryl coenzyme A reductase inhibitor
hypocholesterolemic agent
PCSK9 protein, human
proprotein convertase 9
Article
cardiovascular disease
cost effectiveness analysis
health care cost
human
meta analysis
network meta-analysis
priority journal
quality adjusted life year
secondary prevention
Thailand
cardiovascular disease
combination drug therapy
cost benefit analysis
economics
Markov chain
secondary prevention
Anticholesteremic Agents
Cardiovascular Diseases
Cost-Benefit Analysis
Drug Therapy, Combination
Ezetimibe
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Markov Chains
Network Meta-Analysis
Proprotein Convertase 9
Quality-Adjusted Life Years
Secondary Prevention
Thailand
วันที่เผยแพร่: 2019
บทคัดย่อ: Background: Using non-statin lipid-modifying agents in combination with statin therapy provides additional benefits for cardiovascular disease (CVD) risk reduction, but their value for money has only been evaluated in high-income countries (HICs). Furthermore, studies mainly derive effectiveness data from a single trial or older meta-analyses. Objectives: Our study used data from the most recent network meta-analysis (NMA) and local parameters to assess the cost effectiveness of non-statin agents in statin-treated patients with a history of CVD. Methods: A published Markov model was adopted to investigate lifetime outcomes: (1) number of recurrent CVD events prevented, (2) quality-adjusted life-years (QALYs) gained, (3) costs and (4) incremental cost-effectiveness ratios (ICERs) of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) and ezetimibe added to statin therapy. Event rates and effectiveness inputs were obtained from the NMA. Cost and utility data were gathered from published studies conducted in Thailand. A series of sensitivity analyses were performed. Results: Patients receiving PCSK9i and ezetimibe experienced fewer recurrent CVD events (number needed to treat [NNT] 17 and 30) and more QALYs (0.168 and 0.096 QALYs gained per person). However, under the societal perspective and at current acquisition costs in 2018, ICERs of both agents were $US1,223,995 and 27,361 per QALY gained, respectively. Based on threshold analyses, the costs need to be reduced by 97 and 85%, respectively, for PCSK9i and ezetimibe to be cost-effective. Conclusions: Despite the proven effectiveness of PCSK9i and ezetimibe, the costs of these agents need to reduce to a much greater extent than in HICs to be cost-effective in Thailand. © 2019, Springer Nature Switzerland AG.
URI: https://ir.swu.ac.th/jspui/handle/123456789/12295
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85068326898&doi=10.1007%2fs40273-019-00820-6&partnerID=40&md5=315acc86b58df0935b662f95a1c5db76
ISSN: 11707690
Appears in Collections:Scopus 1983-2021

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