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What is value of addressing unmet needs in high risk CV patients?
The debate hots up
Given the proven ability of PCSK9 inhibitors to lower LDL-cholesterol beyond other agents - alone or in combination - the debate has focused on strategies to define in whom these new agents should be used.
Contributing to the discussion, the Institute for Clinical and Economic Review (ICER) has performed a medico-economic evaluation in high risk patients.
The number of patients needed to treat (NNT) in different patient settings are summarised.
Summary of key outcomes from the analysis
| Target patient population |
Estimated patient group |
NNT over
5 years* |
QALY gained |
| Familial hypercholesterolaemia |
6% |
28 |
$290,000 |
| History of CVD and statin intolerant |
17% |
21 |
$274,000 |
| History of CVD and inadequate LDL-C lowering on statin** |
78% |
21 |
$302,000 |
*To prevent one myocardial infarction over 5 years;
**based on a target LDL cholesterol <70 mg/dl or 1.8 mmol/L; CVD cardiovascular disease; LDL-C low-density lipoprotein cholesterol; QALY quality-adjusted life-year
The implications of the report are discussed here »
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Forward to colleagues »
Tice JA, Kazi DS, Pearson SD. Proprotein Convertase Subtilisin/Kexin Type 9 (PSCK9) inhibitors for treatment of high cholesterol levels. Effectiveness and value. JAMA Intern Med. Published online December 14, 2015. Doi:10.1001/jamainternmed.2015.7248.
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