24 Jun Lowered Price of Repatha® (evolocumab) Translates to Cost Effectiveness for Range of Heart Conditions in Some High Risk Patients
MedicalResearch.com Interview with:
Gregg C. Fonarow, MD, FACC, FAHA
Eliot Corday Professor of Cardiovascular Medicine and Science
Director, Ahmanson-UCLA Cardiomyopathy Center
Co-Chief of Clinical Cardiology, UCLA Division of Cardiology
Co-Director, UCLA Preventative Cardiology Program
David Geffen School of Medicine at UCLA
Los Angeles, CA
MedicalResearch.com: What is the background for this study?
Response: Last year, Amgen made the PCSK-9 inhibitor evolocumab available at a reduced list price of $5,850 per year This 60% reduction was aimed at improving patient access by lowering patient copays, especially for Medicare beneficiaries.
Additionally, the treatment landscape for PCSK9 inhibitors was further defined in 2018 when the American College of Cardiology/American Heart Association Multisociety Clinical Guideline on the Management of Blood Cholesterol recommended PCSK9 inhibitors for, among other patient populations, patients with very high-risk (VHR) ASCVD whose low-density lipoprotein cholesterol levels remain at 70 mg/dL or more despite a heart-healthy lifestyle and treatment with standard background therapy.
MedicalResearch.com: What are the main findings?
Response: The analysis presented in JAMA Cardiology reassess the cost-effectiveness of evolocumab in light of these two important developments. Findings show that, at its current list price, the addition of evolocumab to standard background therapy meets accepted cost-effectiveness thresholds across a range of cardiovascular event rates in patients with very high-risk atherosclerotic cardiovascular disease, as defined by the 2018 ACC/AHA guidelines. Importantly, for the range of baseline CV event rates evaluated in very high-risk ASCVD, all incremental cost-effectiveness ratios were within what the 2018 ACC/AHA guidelines consider high or intermediate value
MedicalResearch.com: What should readers take away from your report?
Response: This analysis adds to the growing body of evidence that underscores the critical role of PCSK9 inhibitors in treating high-risk atherosclerotic cardiovascular disease (ASCVD) patients and reinforces that economic value should not be a barrier to appropriate patients getting access to these important medicines.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: . These results highlight the importance of future analyses that more precisely quantify the baseline CV event rates estimated from patients with VHR ASCVD in the real world to further understand the cost-effectiveness of evolocumab.
MedicalResearch.com: Is there anything else you would like to add?
Response: This study was sponsored by Amgen Inc. The sponsor provided funding for the study and, via employee coauthors, input into the design and conduct of the study; collection, management, and analysis of the data; and interpretation of the data. The sponsor reviewed and approved the manuscript prior to submission, but the coauthors prepared, provided final approval for, and decided to submit the manuscript for publication.
Dr Fonarow reports consulting for Abbott, Amgen, Bayer, Janssen, and Novartis. Dr van Hout reports consulting for Amgen. Drs Villa and Arellano are employees and stockholders of Amgen Inc. Dr Lindgren reports consulting and/or advisory board participation for Amgen, Janssen, MSD, Novartis, and Sanofi. No other disclosures were reported.
Fonarow GC, van Hout B, Villa G, Arellano J, Lindgren P. Updated Cost-effectiveness Analysis of Evolocumab in Patients With Very High-risk Atherosclerotic Cardiovascular Disease. JAMA Cardiol. Published online June 05, 2019. doi:10.1001/jamacardio.2019.1647
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