Analysis: Ezetimibe More Cost-Effective Add-on Therapy for Cardiovascular Events in Type 2 Diabetics

This cost analysis sought to evaluate the treatment costs of evolocumab compared to ezetimibe for the prevention of one major adverse cardiovascular event (MACE). The authors took the number needed to treat from the FOURIER (for evolocumab) and IMPROVE-IT (for ezetimibe) trials, and based drug costs on 2018 U.S. drug prices. They then performed sensitivity and scenario analyses to overcome population variances. The results suggested that annual cost of treatment with evolocumab is $6,540 and $88 with ezetimibe, making the cost of preventing one MACE $678,981 for evolocumab and $10,870 for ezetimibe. “Ezetimibe seems to be a major cost-saving strategy for preventing MACE in this patient population,” the researchers wrote. “Ezetimibe was consistently a cost-saving strategy compared with evolocumab, in all analyses performed, except for the case where evolocumab price is significantly reduced and the branded ezetimibe is used.”


Source: Arbel R, Hammerman A, Azuri J. Am J Cardiol. 2019;doi:10.1016/j.amjcard.2019.01.021