Cost-effectiveness, burden of disease and budget impact of inclisiran : dynamic cohort modelling of a real-world population with cardiovascular disease

Galactionova, Katya; Salari, Paola; Mattli, Renato; Rachamin, Yael; Meier, Rahel; Schwenkglenks, Matthias

doi:10.1007/s40273-022-01152-8

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-25364

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Cost-effectiveness, burden of disease and budget impact of inclisiran : dynamic cohort modelling of a real-world population with cardiovascular disease
Authors:	Galactionova, Katya Salari, Paola Mattli, Renato Rachamin, Yael Meier, Rahel Schwenkglenks, Matthias
et. al:	No
DOI:	10.1007/s40273-022-01152-8 10.21256/zhaw-25364
Published in:	PharmacoEconomics
Volume(Issue):	40
Issue:	8
Page(s):	791
Pages to:	806
Issue Date:	20-Jun-2022
Publisher / Ed. Institution:	Springer
ISSN:	1170-7690 1179-2027
Language:	English
Subjects:	Cardiovascular Disease; Prevention; Management; Public Health; Gesundheitsökonomie
Subject (DDC):	362.1041: Health economics 616: Internal medicine and diseases
Abstract:	Objective: We aimed to estimate the cost-effectiveness, burden of disease and budget impact of inclisiran added to standard-of-care lipid-lowering therapy in the real-world secondary cardiovascular prevention population in Switzerland. Methods: An open-cohort Markov model captured event risks by sex, age and low-density lipoprotein cholesterol based on epidemiological and real-world data. Low-density lipoprotein cholesterol reduction with add-on inclisiran was based on trial results and translated to meta-analysis-based relative risks of cardiovascular events. Unit costs for 2018 were based on publicly available sources, adopting a Swiss healthcare system perspective. Price assumptions of Swiss francs (CHF) 500 and CHF 3,000 per dose of inclisiran were evaluated, combined with uptake assumptions for burden of disease and budget impact. The assessment of cost-effectiveness used a discount rate of 3% per year. We performed deterministic and probabilistic sensitivity analyses, and extensive scenario analyses. Results: Patients treated with inclisiran gained a 0.291 qualityadjusted life-year at an incremental cost per QALY gained of CHF 21,107/228,040 (life-long time horizon, discount rate 3%) under the lower/higher price. Inclisiran prevented 1025 cardiovascular deaths, 3425 acute coronary syndrome episodes, and 1961 strokes in 48,823 patients ever treated during 10 years; the 5-year budget impact was CHF 49.3/573.4 million under the lower/higher price. Estimates were sensitive to calibration targets and treatment eligibility; burden of disease/budget impact results also to uptake. Limitations included uncertainties about model assumptions and the size and characteristics of the population modelled. Conclusions: Inclisiran may be cost-effective at a willingness to pay of CHF 30,000 if priced at CHF 500; a threshold upwards of CHF 250,000 will be required if priced at CHF 3000. Inclisiran could enable important reductions in cardiovascular burden particularly under broader eligibility with a budget impact range from moderate to high depending on price.
URI:	https://digitalcollection.zhaw.ch/handle/11475/25364
Fulltext version:	Published version
License (according to publishing contract):	CC BY-NC 4.0: Attribution - Non commercial 4.0 International
Departement:	School of Management and Law
Organisational Unit:	Winterthur Institute of Health Economics (WIG)
Appears in collections:	Publikationen School of Management and Law

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Galactionova, K., Salari, P., Mattli, R., Rachamin, Y., Meier, R., & Schwenkglenks, M. (2022). Cost-effectiveness, burden of disease and budget impact of inclisiran : dynamic cohort modelling of a real-world population with cardiovascular disease. PharmacoEconomics, 40(8), 791–806. https://doi.org/10.1007/s40273-022-01152-8

Galactionova, K. et al. (2022) ‘Cost-effectiveness, burden of disease and budget impact of inclisiran : dynamic cohort modelling of a real-world population with cardiovascular disease’, PharmacoEconomics, 40(8), pp. 791–806. Available at: https://doi.org/10.1007/s40273-022-01152-8.

K. Galactionova, P. Salari, R. Mattli, Y. Rachamin, R. Meier, and M. Schwenkglenks, “Cost-effectiveness, burden of disease and budget impact of inclisiran : dynamic cohort modelling of a real-world population with cardiovascular disease,” PharmacoEconomics, vol. 40, no. 8, pp. 791–806, Jun. 2022, doi: 10.1007/s40273-022-01152-8.

GALACTIONOVA, Katya, Paola SALARI, Renato MATTLI, Yael RACHAMIN, Rahel MEIER und Matthias SCHWENKGLENKS, 2022. Cost-effectiveness, burden of disease and budget impact of inclisiran : dynamic cohort modelling of a real-world population with cardiovascular disease. PharmacoEconomics. 20 Juni 2022. Bd. 40, Nr. 8, S. 791–806. DOI 10.1007/s40273-022-01152-8

Galactionova, Katya, Paola Salari, Renato Mattli, Yael Rachamin, Rahel Meier, and Matthias Schwenkglenks. 2022. “Cost-Effectiveness, Burden of Disease and Budget Impact of Inclisiran : Dynamic Cohort Modelling of a Real-World Population with Cardiovascular Disease.” PharmacoEconomics 40 (8): 791–806. https://doi.org/10.1007/s40273-022-01152-8.

Galactionova, Katya, et al. “Cost-Effectiveness, Burden of Disease and Budget Impact of Inclisiran : Dynamic Cohort Modelling of a Real-World Population with Cardiovascular Disease.” PharmacoEconomics, vol. 40, no. 8, June 2022, pp. 791–806, https://doi.org/10.1007/s40273-022-01152-8.