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Are PCSK9 Inhibitors Cost Effective?

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Abstract

The objective of this study was to review available health economic evaluations of PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors. These drugs reduce low-density lipid cholesterol levels and cardiovascular risk, but their cost effectiveness has been questioned. We searched Medline and Embase for economic evaluations in any language at any time. Studies were included if they analysed any PCSK9 inhibitor compared with either statin alone or in combination with ezetimibe or any other therapy considered standard prior to the introduction of PCSK9 inhibitors. We found ten full health economic evaluations of PCSK9 inhibitors, two from Europe and eight from the United States (US). Six of the eight from the US were from two different consortia that analysed PCSK9 inhibitors at different stages through the development of evidence. All studies generally reported incremental cost-effectiveness ratios above suggested thresholds for cost effectiveness, except one study from Spain. The results of this review indicate that PCSK9 inhibitors in general are not cost effective at the current prices, but lower prices may change the results.

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Acknowledgements

All authors drafted and revised the manuscript and approved the last version. MJK and TW conducted the search for articles, decided which articles to include, read all articles and summarized them.

Author information

Authors and Affiliations

  1. Ministry of Local Government and Modernisation, Oslo, Norway

    Max J. Korman

  2. Department of Nutrition, University of Oslo, Oslo, Norway

    Kjetil Retterstøl

  3. Lipid Clinic, Oslo University Hospital, Oslo, Norway

    Kjetil Retterstøl

  4. Department of Health Management and Health Economics, University of Oslo, Oslo, Norway

    Ivar Sønbø Kristiansen & Torbjørn Wisløff

  5. Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway

    Torbjørn Wisløff

Authors
  1. Max J. Korman
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  2. Kjetil Retterstøl
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  4. Torbjørn Wisløff
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Corresponding author

Correspondence to Torbjørn Wisløff.

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Funding

The present analysis received no funding and was entirely undertaken by the authors during their regular work hours and/or leisure time.

Conflicts of interest

No funding was received to conduct the work. Mr Korman reports no potential conflicts of interest. Dr Retterstøl reports personal fees and grants from Oslo Economics, Sanofi, Amgen, Achea, Mills DA, Norwegian Directorate of Health, Norwegian Medical Association, MSD and Sunovion in the Nordic Region. Dr Kristiansen reports funding from Amgen through Oslo Economics. Dr Wisløff reports personal fees from Amgen through Oslo Economics.

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Korman, M.J., Retterstøl, K., Kristiansen, I.S. et al. Are PCSK9 Inhibitors Cost Effective?. PharmacoEconomics 36, 1031–1041 (2018). https://doi.org/10.1007/s40273-018-0671-0

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  • DOI: https://doi.org/10.1007/s40273-018-0671-0

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