Presentation (CTI)

OBJECTIVES: The prevalence of hypercholesterolemia was approximately 8.1% in Chinese adults. There were estimated 93.2% patients at high (>1.8 mmol/L) atherosclerotic cardiovascular disease risk did not reach guideline recommended targets for low-density lipoprotein cholesterol (LDL-C). Statins combined with ezetimibe was recommended by guidelines to achieve the LDL-C goal. This study aimed to evaluate the cost-effectiveness of single pill combination (SPC) versus free combination treatment (FCT) of Rosuvastatin 10mg/Ezetimibe 10mg in Chinese hypercholesterolemia adult patients whose LDL-C was not adequately controlled despite on statin monotherapy from the perspective of public healthcare system.
METHODS: A Markov model of seven health states was developed and cardiovascular (CV) events considered in the model included coronary revascularization, non-fatal myocardial infarction, non-fatal ischemic stroke, and CV-related death. The baseline characteristic/CV risk were obtained from a local database study based on hypercholesterolemia patients on statin monotherapy and still did not reach the LDL-C goal. LDL-C reduction of SPC (43.17±16.11)% vs. FCT (29.14±29.13)% (P<0.01) of Rosuvastatin 10mg/Ezetimibe 10mg was derived from a Chinese multicenter observational study. Cost and utilities were obtained from literature and 5% discount rate was applied for both cost and health outcome aligned with China pharmacoeconomic guideline. The willingness-to-pay threshold was set at the 2023 one gross domestic product per capita of China (¥89,358). Sensitivity analysis was performed to explore the uncertainty of model.
RESULTS: Compared with FCT, patients treated with SPC resulted in greater quality-adjusted life years (QALYs) gain of 0.145 and was associated with cost savings of 6,945 RMB per patient over lifetime. Therefore, SPC was considered as a dominant therapy in comparison with FCT of Rosuvastatin 10mg/Ezetimibe 10mg in hypercholesterolemia patients in China.
CONCLUSIONS: SPC demonstrates dominant economic and health value than FCT of Rosuvastatin 10mg/Ezetimibe 10mg in hypercholesterolemia patients whose LDL-C still above target despite on statin monotherapy in China from public healthcare perspective.