Ezetimibe Plus Statin Therapy Yields Greater Cost-Savings vs Evolocumab

stethoscope and bills
stethoscope and bills
Compared with evolocumab, the addition of ezetimibe to statin therapy is a major cost-saving strategy for preventing cardiovascular (CV) death in patients with T2D and an established CV disease.

Ezetimibe plus statin therapy yields greater cost savings than evolocumab plus statin therapy in patients with type 2 diabetes (T2D) and hypercholesterolemia, according to recent research. These results were shared at the Scientific Sessions of the American Heart Association, held on November 10-12, 2018.

In this study, the authors determined the cost of evolocumab vs ezetimibe therapy to prevent major adverse cardiovascular events (MACEs, including stroke, myocardial infarction, and cardiovascular death) in patients with T2D and hypercholesterolemia.

In order to perform a cost-minimization analysis, hazard ratio data were extracted from previously conducted IMPROVE-IT (ClinicalTrials.gov Identifier: NCT00202878) and FOURIER (ClinicalTrials.gov Identifier: NCT01764633) trials, and drug costs were used based on the 2017 US National Average Drug Acquisition Costs.

Evolocumab plus statin therapy prevented 91 MACEs in 12,135 patient-years in the FOURIER trial, whereas ezetimibe plus statin therapy prevented 118 MACEs in 14,754 patient-years in the IMPROVE-IT trial.

The authors estimated the cost needed to prevent one MACE using evolocumab as $1,935,014 (95% CI, $1,237,952-$4,951,806), compared with $48,576 using ezetimibe (95% CI, $30,739-$89,144).

The authors recommend that these results be considered when making treatment decisions for patients with T2D and hypercholesterolemia.

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Azuri J, Hammerman A, Arbel R. Evolocumab vs. ezetimibe in addition to statins for secondary prevention of major adverse cardiovascular events in patients with type 2 diabetes and hypercholesterolemia. Presented at: AHA 2018; November 10-12, 2018; Chicago, Illinois. Abstract Number: Su1085/1085.