To Prevent Cardio Vascular Death in At-Risk Patients With Diabetes: Zetia Appears Cost-Effective Choice

Adding Zetia (ezetimibe) instead of Repatha (evolocumab) to statins to prevent cardiovascular death in patients with type 2 diabetes and established cardiovascular disease appears to be a major cost-savings strategy, researchers shared with attendees at the Scientific Sessions 2018 in Chicago, Illinois.

“[Repatha], a PCSK9 inhibitor, and ezetimibe were both proven to significantly reduce the incidence of major adverse cardiovascular events in type 2 diabetes patients with established cardiovascular disease and low-density lipoprotein (LDL) cholesterol >70 mg/dL treated with statins,” investigators explained. 

“However, the addition of either [Repatha] or [Zetia] to current statin treatment regimens may be a significant burden on healthcare systems.”

For the cost-effectiveness analysis, researchers tapped efficacy data from the FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk) and IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial) trials and analyzed it alongside 2017 drug cost data.

FOURIER data showed [Repatha] prevented 91 major adverse cardiovascular events over 12,135-patient years, according to the abstract. IMPROVE-IT showed ezetimibe prevented 118 major adverse cardiovascular events over 14,754-patient years.

With an annual cost of $14,513 for evolocumab and $389 for generic Zetia, the cost to prevent one major adverse cardiovascular event would be $1.9 million for Repatha compared with $48,576 for Zetia, researchers reported.

While cost-savings with Zetia appear to be significant, researchers clarified that study results should be interpreted alongside drug-specific and individual patient factors. —Jolynn Tumolo