Journal
HEART FAILURE REVIEWS
Volume 25, Issue 6, Pages 1077-1088Publisher
SPRINGER
DOI: 10.1007/s10741-019-09874-2
Keywords
PCSK9 inhibitors; Cardiovascular disease; Cost-effectiveness; Systematic review
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Funding
- health management and economics research center affiliated to Iran University of Medical Sciences [96-03-163-31176, IR.IUMS.REC.1396.31176]
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Aims To assess the cost-effectiveness of pro-protein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in cardiovascular disease. Methods and results We performed a comprehensive search strategy in electronic databases from January 2015 to January 2019. Out of 475 articles, 16 were entered into the study. Quality-adjusted life year, life years gained (LYG), annual cost, and the incremental cost-effectiveness ratio (ICER) regarding the use of PCSK9 inhibitors were considered as the key outcomes. The cost-effectiveness threshold varied from $45,000 in Spain to $150,000 in the USA. The annual cost of PCSK9 inhibitors for studies undertaken in the USA was in the range of $14,000 to $15,000, while it was about $7000 for other developed countries. The results showed that reduction in the price of PCSK9 inhibitors changed from 20 to 88%. The means of QALY were 0.65 and 0.67 in the Markov and Cardiovascular Disease Policy Modeling (CVDPM) models; also, the ICER means were $197,707 and $625,555 for the Markov and CVDPM model, respectively. Conclusion According to the current study, the effectiveness of PCSK9 inhibitors is well documented, although all studies pointed out a higher cost of these inhibitors.
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