| Title: |
Cost-effectiveness of lipid lowering with statins and ezetimibe in chronic kidney disease |
| Authors: |
Schlackow, I; Kent, S; Herrington, W; Emberson, J; Haynes, R; Reith, C; Collins, R; Landray, MJ; Gray, A; Baigent, C; Mihaylova, B; Baxter, A; Young, A; Hill, M; Knott, C; Cass, A; Feldt-Rasmussen, B; Fellstrom, B; Grobbee, DE; Gronhagen-Riska, C; Haas, M; Holdaas, H; Hooi, LS; Jiang, L; Kasiske, B; Krairittichai, U; Levin, A; Massy, ZA; Tesar, V; Walker, R; Wanner, C; Wheeler, DC; Wiecek, A; Dasgupta, T; Lewis, D; Mafham, M; Majoni, W; Parish, S; Simpson, D; Strony, J; Musliner, T; Agodoa, L; Armitage, J; Chen, Z; Craig, J; de Zeeuw, D; Gaziano, JM; Grimm, R; Krane, V; Neal, B; Ophascharoensuk, V; Pedersen, T; Sleight, P; Tobert, J; Tomson, C |
| Source: |
Kidney International , 96 (1) pp. 170-179. (2019) |
| Publisher Information: |
ELSEVIER SCIENCE INC |
| Publication Year: |
2019 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
chronic kidney disease; cost-effectiveness; ezetimibe; health care costs; quality-adjusted life years; statin |
| Description: |
Statin-based treatments reduce cardiovascular disease (CVD) risk in patients with non-dialysis chronic kidney disease (CKD), but it is unclear which regimen is the most cost-effective. We used the Study of Heart and Renal Protection (SHARP) CKD-CVD policy model to evaluate the effect of statins and ezetimibe on quality-adjusted life years (QALYs) and health care costs in the United States (US) and the United Kingdom (UK). Net costs below $100,000/QALY (US) or £20,000/QALY (UK) were considered cost-effective. We investigated statin regimens with or without ezetimibe 10 mg. Treatment effects on cardiovascular risk were estimated per 1-mmol/L reduction in low-density lipoprotein (LDL) cholesterol as reported in the Cholesterol Treatment Trialists’ Collaboration meta-analysis, and reductions in LDL cholesterol were estimated for each statin/ezetimibe regimen. In the US, atorvastatin 40 mg ($0.103/day as of January 2019) increased life expectancy by 0.23 to 0.31 QALYs in non-dialysis patients with stages 3B to 5 CKD, at a net cost of $20,300 to $78,200/QALY. Adding ezetimibe 10 mg ($0.203/day) increased life expectancy by an additional 0.05 to 0.07 QALYs, at a net cost of $43,600 to $91,500/QALY. The cost-effectiveness findings and policy implications in the UK were similar. In summary, in patients with non-dialysis-dependent CKD, the evidence suggests that statin/ezetimibe combination therapy is a cost-effective treatment to reduce the risk of CVD. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10078789/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10078789/1/Wheeler_Cost-effectiveness%20of%20lipid%20lowering%20with%20statins%20and%20ezetimibe%20in%20chronic%20kidney%20disease_VoR.pdf; https://discovery.ucl.ac.uk/id/eprint/10078789/ |
| Rights: |
open |
| Accession Number: |
edsbas.9D03677D |
| Database: |
BASE |