To be cost-effective, the price of alirocumab would have to be reduced significantly, according to results published in the Annals of Internal Medicine. The results indicated that the price have alirocumab would have to decrease from its original cost of $14,560 to $1974 annually to make use of the drug cost-effective.
The researchers performed an analysis based on the results of the Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab trial (ODYSSEY Outcomes; ClinicalTrials.gov Identifier: NCT01663402), which included participants with recent acute coronary syndrome.
Participants receiving a statin plus alirocumab had lower rates of myocardial infarction, stroke, and death compared with those who received statins alone.
In their current analysis, the researchers sought to determine whether alirocumab was cost-effective in these circumstances compared with ezetimibe. The outcome measure was incremental cost-effectiveness ratio on 2018 US dollars per quality-adjusted life-year (QALY) gained.
Adding ezetimibe to a statin drug cost $81,000 per QALY compared with a statin alone, while the addition of alirocumab to a statin drug cost $308,000 per QALY compared with a statin alone. Compared with the combination of a statin and ezetimibe, the combination of a statin and alirocumab cost $997,000 more per QALY.
“Despite the substantial cardiovascular benefit of alirocumab, its wholesale price…would have to be reduced by 86% to meet a conventional willingness-to-pay threshold of $100,000 per QALY,” the study authors stated.
“We encourage other members of the academic community to become involved in evaluating the cost-effectiveness of new therapies in a timely manner,” they concluded.
Drs. Kazi and Coxson and Ms. Penko report receiving grants from the Institute for Clinical and Economic Review. Please refer to original reference text for comprehensive list of author disclosures.
Kazi DS, Penko J, Coxson PG, Guzman D, Wei PC, Bibbins-Domingo K. Cost-effectiveness of alirocumab: a just-in-time analysis based on the ODYSSEY outcomes trial [published online January 1, 2019]. Ann Intern Med. doi:10.7326/M18-1776