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408 results on '"van Hout, Ben A"'

2. Cost-effectiveness of PCSK9 inhibition with evolocumab in patients with a history of myocardial infarction in Sweden

Author

Landmesser, Ulf, Lindgren, Peter, Hagström, Emil, van Hout, Ben, Villa, Guillermo, Pemberton-Ross, Peter, Arellano, Jorge, Svensson, Maria Eriksson, Sibartie, Mahendra, and Fonarow, Gregg C

Subjects
Clinical Research, Cost Effectiveness Research, Patient Safety, Heart Disease - Coronary Heart Disease, Comparative Effectiveness Research, Heart Disease, Cardiovascular, Good Health and Well Being, Antibodies, Monoclonal, Humanized, Anticholesteremic Agents, Cost-Benefit Analysis, Humans, Myocardial Infarction, Subtilisins, Sweden, Cost-effectiveness, Evolocumab, Low-density lipoprotein cholesterol, Myocardial infarction, PCSK9 inhibitors, Statins
Abstract

AimsTo 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 resultsCost-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.ConclusionProprotein 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.

Published
2022

9. Cost‐Effectiveness of LDL‐C Lowering With Evolocumab in Patients With High Cardiovascular Risk in the United States

Author

Gandra, Shravanthi R, Villa, Guillermo, Fonarow, Gregg C, Lothgren, Mickael, Lindgren, Peter, Somaratne, Ransi, and van Hout, Ben

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Trials and Supportive Activities, Clinical Research, Cardiovascular, Atherosclerosis, Heart Disease, Comparative Effectiveness Research, Prevention, Cost Effectiveness Research, Good Health and Well Being, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Anticholesteremic Agents, Biomarkers, Cardiovascular Diseases, Cholesterol, LDL, Clinical Trials, Phase III as Topic, Cost-Benefit Analysis, Down-Regulation, Drug Costs, Drug Therapy, Combination, Dyslipidemias, Female, Humans, Male, Markov Chains, Middle Aged, Models, Economic, Quality-Adjusted Life Years, Randomized Controlled Trials as Topic, Recurrence, Risk Factors, Time Factors, Treatment Outcome, United States, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

Randomized trials have shown marked reductions in low-density lipoprotein cholesterol (LDL-C), a risk factor for cardiovascular disease (CVD), when evolocumab is administered. We hypothesized that evolocumab added to standard of care (SOC) vs SOC alone is cost-effective in the treatment of patients with heterozygous familial hypercholesterolemia (HeFH) or atherosclerotic CVD (ASCVD) with or without statin intolerance and LDL-C >100 mg/dL. Using a Markov cohort state transition model, primary and recurrent CVD event rates were predicted considering population-specific trial-based mean risk factors and calibrated against observed rates in the real world. The LDL-C-lowering effect from population-specific phase 3 randomized studies for evolocumab was used together with estimated LDL-C-lowering effect on CVD event rates per 38.67-mg/dL LDL-C lowering from a statin-trial meta-analysis. Costs and utilities were included from published sources. Evolocumab treatment was associated with both increased cost and improved quality-adjusted life-years (QALY): HeFH (incremental cost: US$153 289, incremental QALY: 2.02, incremental cost-effectiveness ratio: US$75 863/QALY); ASCVD (US$158 307, 1.12, US$141 699/QALY); and ASCVD with statin intolerance (US$136 903, 1.36, US$100 309/QALY). Evolocumab met both the American College of Cardiology/American Heart Association (ACC/AHA) and World Health Organization (WHO) thresholds in each population evaluated. Sensitivity and scenario analyses confirmed that model results were robust to changes in model parameters. Among patients with HeFH and ASCVD with or without statin intolerance, evolocumab added to SOC may provide a cost-effective treatment option for lowering LDL-C using ACC/AHA intermediate/high value and WHO cost-effectiveness thresholds. More definitive information on the clinical and economic value of evolocumab will be available from the forthcoming CVD outcomes study.

Published
2016

27. Cost-effectiveness of proprotein convertase subtilisin/kexin type 9 inhibition with evolocumab in patients with a history of myocardial infarction in Sweden

Author

Landmesser, Ulf, Lindgren, Peter, Hagström, Emil, van Hout, Ben, Villa, Guillermo, Pemberton-Ross, Peter, Arellano, Jorge, Svensson, Maria K., Sibartie, Mahendra, Fonarow, Gregg C, Landmesser, Ulf, Lindgren, Peter, Hagström, Emil, van Hout, Ben, Villa, Guillermo, Pemberton-Ross, Peter, Arellano, Jorge, Svensson, Maria K., Sibartie, Mahendra, and Fonarow, Gregg C

Abstract

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.

Published
2022
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