{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T21:47:14Z","timestamp":1781560034111,"version":"3.54.5"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,4,19]],"date-time":"2016-04-19T00:00:00Z","timestamp":1461024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2016,6]]},"abstract":"ABSTRACT<\/jats:title>Randomized trials have shown marked reductions in low\u2010density lipoprotein cholesterol (LDL<\/jats:styled-content>\u2010C), a risk factor for cardiovascular disease (CVD<\/jats:styled-content>), when evolocumab is administered. We hypothesized that evolocumab added to standard of care (SOC<\/jats:styled-content>) vsSOC<\/jats:styled-content>alone is cost\u2010effective in the treatment of patients with heterozygous familial hypercholesterolemia (HeFH<\/jats:styled-content>) or atheroscleroticCVD<\/jats:styled-content>(ASCVD<\/jats:styled-content>) with or without statin intolerance andLDL<\/jats:styled-content>\u2010C >100\u2009mg\/dL<\/jats:styled-content>. Using a Markov cohort state transition model, primary and recurrentCVD<\/jats:styled-content>event rates were predicted considering population\u2010specific trial\u2010based mean risk factors and calibrated against observed rates in the real world. TheLDL<\/jats:styled-content>\u2010C\u2013lowering effect from population\u2010specific phase 3 randomized studies for evolocumab was used together with estimatedLDL<\/jats:styled-content>\u2010C\u2013lowering effect onCVD<\/jats:styled-content>event rates per 38.67\u2010mg\/dL LDL<\/jats:styled-content>\u2010C lowering from a statin\u2010trial meta\u2010analysis. Costs and utilities were included from published sources. Evolocumab treatment was associated with both increased cost and improved quality\u2010adjusted life\u2010years (QALY<\/jats:styled-content>):HeFH<\/jats:styled-content>(incremental cost:US<\/jats:styled-content>$153\u2009289, incrementalQALY<\/jats:styled-content>: 2.02, incremental cost\u2010effectiveness ratio:US<\/jats:styled-content>$75\u2009863\/QALY<\/jats:styled-content>);ASCVD<\/jats:styled-content>(US<\/jats:styled-content>$158\u2009307, 1.12,US<\/jats:styled-content>$141\u2009699\/QALY<\/jats:styled-content>); andASCVD<\/jats:styled-content>with statin intolerance (US<\/jats:styled-content>$136\u2009903, 1.36,US<\/jats:styled-content>$100\u2009309\/QALY<\/jats:styled-content>). Evolocumab met both the American College of Cardiology\/American Heart Association (ACC<\/jats:styled-content>\/AHA<\/jats:styled-content>) and World Health Organization (WHO<\/jats:styled-content>) thresholds in each population evaluated. Sensitivity and scenario analyses confirmed that model results were robust to changes in model parameters. Among patients withHeFH<\/jats:styled-content>andASCVD<\/jats:styled-content>with or without statin intolerance, evolocumab added toSOC<\/jats:styled-content>may provide a cost\u2010effective treatment option for loweringLDL<\/jats:styled-content>\u2010C usingACC<\/jats:styled-content>\/AHA<\/jats:styled-content>intermediate\/high value andWHO<\/jats:styled-content>cost\u2010effectiveness thresholds. More definitive information on the clinical and economic value of evolocumab will be available from the forthcomingCVD<\/jats:styled-content>outcomes study.<\/jats:p>","DOI":"10.1002\/clc.22535","type":"journal-article","created":{"date-parts":[[2016,4,19]],"date-time":"2016-04-19T20:56:51Z","timestamp":1461099411000},"page":"313-320","source":"Crossref","is-referenced-by-count":75,"title":["Cost\u2010Effectiveness ofLDL<\/scp>\u2010C Lowering With Evolocumab in Patients With High Cardiovascular Risk in the United States"],"prefix":"10.1002","volume":"39","author":[{"given":"Shravanthi R.","family":"Gandra","sequence":"first","affiliation":[{"name":"Department of Global Health Economics, Amgen Inc. 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