Evolocumab yields lower cost per effectively treated patient vs. alirocumab

NEW ORLEANS — The cost per effectively treated patient was lower with the PCSK9 inhibitor evolocumab compared with alirocumab over a 1-year period, according to analysis presented at the National Lipid Association Scientific Sessions.

Based on data from 7,682 real-world patients (mean age, 62 years; 44% women) with atherosclerotic CVD or heterozygous familial hypercholesterolemia, researchers estimated the cost per effectively treated patient for evolocumab (Repatha, Amgen) 140 mg, alirocumab (Praluent, Sanofi/Regeneron) 75 mg and alirocumab 150 mg. For this study, effectively treated patients were defined as those with less than a 50% reduction in LDL, post-treatment LDL or both.

The researchers constructed an economic model based on efficacy estimates from meta-analyses (evolocumab 140 mg, 63.46%; alirocumab 75 mg, 52.63%; alirocumab 150 mg, 56.15%) and annual wholesale acquisition cost as of December 2015 (evolocumab, $14,138; alirocumab, $14,600).

Overall, 28.9% of the real-world patients had LDL 100 mg/dL (mean, 134 mg/dL).

Annual cost per effectively treated patient as defined by > 50% reduction in LDL was $18,516 for evolocumab 140 mg, $24,069 for alirocumab 75 mg and $22,192 for alirocumab 150 mg, according to the researchers.

Annual cost per effectively treated patient as defined by post-treatment LDL < 70 mg/dL was $17,295 for evolocumab 140 mg, $21,733 for alirocumab 75 mg and $20,269 for alirocumab 150 mg. By the composite metric, the annual cost per effectively treated patient was $16,842 for evolocumab 140 mg, $20,463 for alirocumab 75 mg and $19,376 for alirocumab 150 mg.

“The cost per effectively treated patient regardless of definition ... suggests that evolocumab produces a better economic outcome when compared to alirocumab 75 mg and alirocumab 150 mg over 1 year,” Matthew Gitlin, PharmD, founder and managing director of Bluepath Solutions and volunteer assistant professor at the School of Pharmacy, University of California, San Francisco, and colleagues wrote in an abstract. – by Erik Swain

Reference:

Gitlin M, et al. Abstract 144. Presented at: National Lipid Association Scientific Sessions; May 19-22, 2016; New Orleans.
Disclosure: The study was funded by Amgen. Gitlin reports being founder and managing director of Bluepath Solutions, which received research funding from Amgen.