RESUMEN
BACKGROUND: Bempedoic acid is a novel adenosine triphosphate citrate lyase inhibitor shown to reduce low density lipoprotein cholesterol when used as an adjunct lipid-lowering therapy in patients with high cardiovascular disease (CVD) risk. OBJECTIVE: Our analysis aimed to determine the price at which bempedoic acid would be cost-effective from the Australian health care perspective. METHODS: A Markov model was designed using data from the Cholesterol Lowering via Bempedoic Acid, an ACL-Inhibiting Regimen (CLEAR) Harmony trial, to model the clinical outcomes and costs of 1000 patients treated with bempedoic acid over a lifetime horizon. Relevant health states were "Alive with CVD," "Alive with recurrent CVD," and "Dead." With annual cycles, patients were at risk of a nonfatal myocardial infarction, coronary revascularization, and death from CVD or non-CVD causes. Costs and utilities were obtained from published sources. Outcomes of interest were the incremental cost-effectiveness ratios in terms of cost per quality-adjusted life year (QALY) gained and cost per year of life saved. Outcomes were discounted at 5% per annum. RESULTS: Among 1000 individuals, bempedoic acid in addition to statin therapy was estimated to save 122 (discounted) years of life and 103 (discounted) QALYs compared with statin therapy alone. At an acquisition cost of AU$584.40 per year (USD$397.01), bempedoic acid would be considered cost-effective within the Australian setting, with an incremental cost-effectiveness ratio of AU$49,890 per QALY gained (USD$33,893) and AU$42,433 per year of life saved (USD$28,827). CONCLUSIONS: Bempedoic acid may be cost-effective within the Australian health care setting at an annual acquisition price less than $600.
Asunto(s)
Enfermedades Cardiovasculares/tratamiento farmacológico , Análisis Costo-Beneficio , Ácidos Dicarboxílicos/economía , Ácidos Grasos/economía , Hipolipemiantes/economía , Enfermedades Cardiovasculares/economía , Ácidos Dicarboxílicos/uso terapéutico , Ácidos Grasos/uso terapéutico , Humanos , Hipolipemiantes/uso terapéutico , Cadenas de Markov , Años de Vida Ajustados por Calidad de Vida , RiesgoAsunto(s)
Ácidos Dicarboxílicos/administración & dosificación , Ivermectina/administración & dosificación , Metronidazol/administración & dosificación , Rosácea/tratamiento farmacológico , Administración Tópica , Ácidos Dicarboxílicos/economía , Costos de los Medicamentos , Humanos , Ivermectina/economía , Metronidazol/economía , Medición de Resultados Informados por el PacienteAsunto(s)
Fármacos Dermatológicos/uso terapéutico , Ácidos Dicarboxílicos/uso terapéutico , Rosácea/tratamiento farmacológico , Administración Tópica , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/economía , Ácidos Dicarboxílicos/administración & dosificación , Ácidos Dicarboxílicos/economía , Relación Dosis-Respuesta a Droga , Honorarios Farmacéuticos , Humanos , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Precise classification methods are used to define acne according to type (comedonal, papulopustular, or nodular) and severity. The relative effectiveness of several topical and systemic agents has been established in clinical trials, making possible an algorithm of specific treatment decisions based on acne classification.
Asunto(s)
Acné Vulgar/tratamiento farmacológico , Acné Vulgar/economía , Fármacos Dermatológicos/economía , Fármacos Dermatológicos/uso terapéutico , Acné Vulgar/clasificación , Acné Vulgar/patología , Adapaleno , Administración Oral , Administración Tópica , Algoritmos , Antibacterianos/economía , Antibacterianos/uso terapéutico , Peróxido de Benzoílo/economía , Peróxido de Benzoílo/uso terapéutico , Anticonceptivos Orales/economía , Anticonceptivos Orales/uso terapéutico , Ensayos Clínicos Controlados como Asunto , Análisis Costo-Beneficio , Árboles de Decisión , Ácidos Dicarboxílicos/economía , Ácidos Dicarboxílicos/uso terapéutico , Humanos , Isotretinoína/economía , Isotretinoína/uso terapéutico , Macrólidos , Naftalenos/economía , Naftalenos/uso terapéutico , Ácidos Nicotínicos/economía , Ácidos Nicotínicos/uso terapéutico , Salicilatos/economía , Salicilatos/uso terapéutico , Tretinoina/economía , Tretinoina/uso terapéutico , Estados UnidosRESUMEN
Azelaic acid is another option for the topical treatment of mild to moderate inflammatory acne vulgaris. It offers effectiveness similar to that of other agents without the systemic side effects of oral antibiotics or the allergic sensitization of topical benzoyl peroxide and with less irritation than tretinoin. Azelaic acid is less expensive than certain other prescription acne preparations, but it is much more expensive than nonprescription benzoyl peroxide preparations. Whether it is safe and effective when used in combination with other agents is not known.
