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Dr Clifford Goodman Outlines Takeaways From a Health Economic Case Study on Repatha

During an industry workshop at the Academy of Managed Care Pharmacy Annual Meeting in Denver, Colorado, Cliff Goodman, PhD, of the Lewin Group, moderated a session that provided a health economic case study on cardiovascular outcome data for Repatha (evolocumab), the PCSK9 inhibitor from Amgen.
During an industry workshop at the Academy of Managed Care Pharmacy Annual Meeting in Denver, Colorado, Cliff Goodman, PhD, of the Lewin Group, moderated a session that provided a health economic case study on cardiovascular outcome data for Repatha (evolocumab), the PCSK9 inhibitor from Amgen.
 
Study results on Repatha’s ability to cut cardiovascular death, heart attack, or stroke were recently presented at the 66th Scientific Session of the American College of Cardiology.
 
Goodman moderated a discussion between speakers Ransi Somaratne, MD, FACC, of Amgen, and Tanya GK Bentley, PhD, of the Partnership for Health Analytic Research, LLC, and recapped the takeaways of the discussion.
 
What was the key takeaway from the workshop?
The 3 main points of the workshop were basically that, whenever we seek to evaluate the value of a product the modeling inputs matter. The results of these value assessments depend and are driven by the assumptions we make in the inputs to the models. That’s the first point. So when you evaluate the value of a product, you’ve got to pay close attention to the modeling inputs.
 
The second one, because this was a cardiovascular therapy, is that it was clear that the main determining factors of the modeling assessment were the efficacy of the therapy in the indicated population and the cardiovascular event rates that were entered into the model. And by cardiovascular event rates, I mean the rate of cardiovascular events that would be experienced in the target population.
 
And then another point is that, if you ascribe to general accepted thresholds—or I should say, ascribe to increasingly accepted thresholds—of cost-effectiveness based on cost per quality-adjusted life-year (QALY) gained, I was just the moderator but the analyses presented by our expert speakers suggest that this product, evolocumab, would be cost-effective. I would say it might be in the neighborhood of approximately $100,000 to $150,000 per QALY gained. And importantly, that result depends on the use of available data, and the available real-world data, on cardiovascular event rates.
 
So those are the 3 main points: the first one was modeling inputs matter; the second one was, in cardiovascular therapies, efficacy and real-world cardiovascular event rates matter; and the third one is that if we kind of roll these assumptions and data sources and if we ascribe to increasingly accepted cost-effectiveness thresholds (eg, between $100,000 and $150,000 per QALY gained), it would appear that this therapy is cost-effective.
 


 
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