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. 2021 Nov 2:8:155-167.
doi: 10.33393/grhta.2021.2255. eCollection 2021 Jan-Dec.

Analisi di costo-utilità di evolocumab in pazienti con ASCVD in Italia

[Article in Italian]
Andrea Marcellusi  1   2 , Chiara Bini  1 , Maria Assunta Rotundo  1 , Emanuela Arcangeli  3 , Laura Martinez  4 , Francesc Sorio Vilela  4 , Francesco Saverio Mennini  1   2
Affiliations

Analisi di costo-utilità di evolocumab in pazienti con ASCVD in Italia

[Article in Italian]
Andrea Marcellusi et al. Glob Reg Health Technol Assess. .

Abstract

Objective:: The aim of this work was to evaluate the cost-effectiveness of evolocumab in addition to standard statin therapy with or without ezetimibe in the treatment of patients with clinically evident atherosclerotic cardiovascular disease (ASCVD) with levels of LDL-C above 100 mg/dL.

Method:: A theoretical cohort of patients was forecast by a Markov model that includes 11 health states for a lifetime horizon. In the base-case, the standard therapy was characterized by statins with or without ezetimibe. Two sub-populations have been considered, Recent MI (Myocardial Infarction in the last year) and Multiple events (population with multiple MI). The results were also presented for a subset of the Multiple events populations consisting of patients who have experienced a myocardial infarction (MI) in the last year.

Results:: For the Recent MI and Multiple events populations, ICER values of € 39,547 and € 35,744 respectively were estimated. The value of ICER was lower for the Multiple events with MI < 1 year population (€ 29,949). Considering statins with ezetimibe as standard therapy, ICER values were found to be equal to € 39,781, € 35,986 and € 30,190 respectively for the populations Recent MI, Multiple events and Multiple events with MI < 1 year.

Conclusions:: The estimated ICER values for the Recent MI, Multiple events and Multiple events populations with MI < 1 year were below the cost-effectiveness threshold of € 40,000, suggesting therefore how the treatment with evolocumab in addition to the standard therapy can be a cost-effective treatment both compared to standard therapy with statins and standard therapy with statins + ezetimibe.

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Conflict of interest statement

Conflict of interest: AM, CB, MAR and FSM have no conflict of interest. EA, LM, FS are employees of AMGEN.

Figures

Fig. 1 -
Fig. 1 -
Struttura del modello. ASCVD: atherosclerotic cardiovascular disease; CV: cardiovascular disease; IS: ischemic stroke; MI: myocardial infarction; RV: revascularization.
Fig. 2 -
Fig. 2 -
Grafico tornado. Popolazioni Recent MI (A), Multiple events (B), Multiple events MI < 1 anno (C).
Fig. 3 -
Fig. 3 -
Curva di accettabilità di costo-efficacia (CEAC). Popolazioni Recent MI (A), Multiple events (B), Multiple events MI < 1 anno (C).
See this image and copyright information in PMC

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