Evidence mapPaperPMID 27092712Full record

SynthesisClinical cardiology2016

Cost-Effectiveness of LDL-C Lowering With Evolocumab in Patients With High Cardiovascular Risk in the United States.

Shravanthi R Gandra, Guillermo Villa, Gregg C Fonarow, Mickael Lothgren, Peter Lindgren, Ransi Somaratne, Ben van Hout

Erratum issuedAbstract readMeta-Analysis
In one paragraph

Synthesis in Clinical cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 40 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 4 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Guideline
  5. Trial
  6. Article
  7. Non-histone lactylation: unveiling its functional significance.Frontiers in cell and developmental biology · 2025
    Review
  8. Review
  9. Cost-effectiveness of Evolocumab in Cardiovascular Disease: A Systematic Review.Current therapeutic research, clinical and experimental · 2024
    Review
  10. Article
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Effect of Access to Prescribed PCSK9 Inhibitors on Cardiovascular Outcomes.Circulation. Cardiovascular quality and outcomes · 2019
    Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Shravanthi R GandraDepartment of Global Health Economics, Amgen Inc., Thousand Oaks, California.
Guillermo VillaEconomic Modeling Center, Amgen (Europe) GmbH, Zug, Switzerland.
Gregg C FonarowAhmanson-UCLA Cardiomyopathy Center, Division of Cardiology, Geffen-UCLA School of Medicine, Los Angeles, California.
Mickael LothgrenEconomic Modeling Center, Amgen (Europe) GmbH, Zug, Switzerland.
Peter LindgrenDepartment of Health Economics, the Swedish Institute for Health Economics, Lund, Sweden.
Ransi SomaratneDepartment of Clinical Development, Amgen Inc., Thousand Oaks, California.
Ben van HoutDepartment of Health Economics, University of Sheffield, Sheffield, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Randomized trials have shown marked reductions in low-density lipoprotein cholesterol (LDL-C), a risk factor for cardiovascular disease (CVD), when evolocumab is administered. We hypothesized that evolocumab added to standard of care (SOC) vs SOC alone is cost-effective in the treatment of patients with heterozygous familial hypercholesterolemia (HeFH) or atherosclerotic CVD (ASCVD) with or without statin intolerance and LDL-C >100 mg/dL. Using a Markov cohort state transition model, primary and recurrent CVD event rates were predicted considering population-specific trial-based mean risk factors and calibrated against observed rates in the real world. The LDL-C-lowering effect from population-specific phase 3 randomized studies for evolocumab was used together with estimated LDL-C-lowering effect on CVD event rates per 38.67-mg/dL LDL-C lowering from a statin-trial meta-analysis. Costs and utilities were included from published sources. Evolocumab treatment was associated with both increased cost and improved quality-adjusted life-years (QALY): HeFH (incremental cost: US$153 289, incremental QALY: 2.02, incremental cost-effectiveness ratio: US$75 863/QALY); ASCVD (US$158 307, 1.12, US$141 699/QALY); and ASCVD with statin intolerance (US$136 903, 1.36, US$100 309/QALY). Evolocumab met both the American College of Cardiology/American Heart Association (ACC/AHA) and World Health Organization (WHO) thresholds in each population evaluated. Sensitivity and scenario analyses confirmed that model results were robust to changes in model parameters. Among patients with HeFH and ASCVD with or without statin intolerance, evolocumab added to SOC may provide a cost-effective treatment option for lowering LDL-C using ACC/AHA intermediate/high value and WHO cost-effectiveness thresholds. More definitive information on the clinical and economic value of evolocumab will be available from the forthcoming CVD outcomes study.

Indexed as

Drug CostsAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedAnticholesteremic AgentsBiomarkersCardiovascular DiseasesCholesterol, LDLClinical Trials, Phase III as TopicCost-Benefit AnalysisDown-RegulationDrug Therapy, CombinationDyslipidemiasFemaleHumansMaleMarkov ChainsAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedAnticholesteremic AgentsBiomarkersCholesterol, LDLevolocumab

Identifiers

PMID27092712
PMCPMC5074319

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.