| Title: |
Cost-effectiveness of lipid lowering with statins and ezetimibe in chronic kidney disease |
| Authors: |
Schlackow,Iryna; Kent,Seamus; Herrington,W.; Emberson,Jonathan; Haynes,Richard; Reith,Christina; Collins,Rory; Landray,Martin J.; Gray,Alastair; Baigent,Colin; Mihaylova,Borislava; Collins,R.; Bray,C.; Chen,Y.; Baxter,A.; Young,A.; Hill,M.; Knott,C.; Cass,A.; Feldt-Rasmussen,B.; Fellström,B.; Grobbee, D. E.; Grönhagen-Riska,C.; Haas, M.; Holdaas,H.; Hooi,L. S.; Jiang, L.; Kasiske,B.; Krairittichai,U.; Levin,A.; Massy,Z. A.; Tesar,V.; Walker,R.; Wanner,C.; Wheeler,D. C.; Wiecek,A.; Dasgupta,T.; Lewis,D.; Mafham,M.; Majoni,W.; Reith,C.; Parish,S.; Simpson,D.; Strony,J.; Musliner,T.; Agodoa,L.; Armitage,J.; Chen,Z.; Craig,J.; de Zeeuw,D.; Gaziano,J. M.; Grimm,R.; Krane,V.; Neal,B.; Ophascharoensuk,V.; Pedersen,T.; Sleight,P.; Tobert,J.; Tomson,C.; Global Health; Circulatory Health; JC onderzoeksprogramma Cardiovascular Health; Cardiovasculaire Epi Team 9; Cardiometabolic Health; CDL Nanomedicine |
| Publication Year: |
2019 |
| Subject Terms: |
chronic kidney disease; cost-effectiveness; ezetimibe; health care costs; quality-adjusted life years; statin; Nephrology |
| 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/plain |
| Language: |
English |
| ISSN: |
0085-2538 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/457732 |
| Availability: |
https://dspace.library.uu.nl/handle/1874/457732 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.AC12FFC1 |
| Database: |
BASE |