dc.contributor.author |
Kongpakwattana K. |
|
dc.contributor.author |
Ademi Z. |
|
dc.contributor.author |
Chaiyasothi T. |
|
dc.contributor.author |
Nathisuwan S. |
|
dc.contributor.author |
Zomer E. |
|
dc.contributor.author |
Liew D. |
|
dc.contributor.author |
Chaiyakunapruk N. |
|
dc.date.accessioned |
2021-04-05T03:02:38Z |
|
dc.date.available |
2021-04-05T03:02:38Z |
|
dc.date.issued |
2019 |
|
dc.identifier.issn |
11707690 |
|
dc.identifier.other |
2-s2.0-85068326898 |
|
dc.identifier.uri |
https://ir.swu.ac.th/jspui/handle/123456789/12295 |
|
dc.identifier.uri |
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85068326898&doi=10.1007%2fs40273-019-00820-6&partnerID=40&md5=315acc86b58df0935b662f95a1c5db76 |
|
dc.description.abstract |
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. |
|
dc.subject |
ezetimibe |
|
dc.subject |
hydroxymethylglutaryl coenzyme A reductase inhibitor |
|
dc.subject |
proprotein convertase 9 inhibitor |
|
dc.subject |
serine proteinase inhibitor |
|
dc.subject |
unclassified drug |
|
dc.subject |
ezetimibe |
|
dc.subject |
hydroxymethylglutaryl coenzyme A reductase inhibitor |
|
dc.subject |
hypocholesterolemic agent |
|
dc.subject |
PCSK9 protein, human |
|
dc.subject |
proprotein convertase 9 |
|
dc.subject |
Article |
|
dc.subject |
cardiovascular disease |
|
dc.subject |
cost effectiveness analysis |
|
dc.subject |
health care cost |
|
dc.subject |
human |
|
dc.subject |
meta analysis |
|
dc.subject |
network meta-analysis |
|
dc.subject |
priority journal |
|
dc.subject |
quality adjusted life year |
|
dc.subject |
secondary prevention |
|
dc.subject |
Thailand |
|
dc.subject |
cardiovascular disease |
|
dc.subject |
combination drug therapy |
|
dc.subject |
cost benefit analysis |
|
dc.subject |
economics |
|
dc.subject |
Markov chain |
|
dc.subject |
secondary prevention |
|
dc.subject |
Anticholesteremic Agents |
|
dc.subject |
Cardiovascular Diseases |
|
dc.subject |
Cost-Benefit Analysis |
|
dc.subject |
Drug Therapy, Combination |
|
dc.subject |
Ezetimibe |
|
dc.subject |
Humans |
|
dc.subject |
Hydroxymethylglutaryl-CoA Reductase Inhibitors |
|
dc.subject |
Markov Chains |
|
dc.subject |
Network Meta-Analysis |
|
dc.subject |
Proprotein Convertase 9 |
|
dc.subject |
Quality-Adjusted Life Years |
|
dc.subject |
Secondary Prevention |
|
dc.subject |
Thailand |
|
dc.title |
Cost-Effectiveness Analysis of Non-Statin Lipid-Modifying Agents for Secondary Cardiovascular Disease Prevention Among Statin-Treated Patients in Thailand |
|
dc.type |
Article |
|
dc.rights.holder |
Scopus |
|
dc.identifier.bibliograpycitation |
PharmacoEconomics. Vol 37, No.10 (2019), p.1277-1286 |
|
dc.identifier.doi |
10.1007/s40273-019-00820-6 |
|