OBJECTIVES: First in a new class of cholesterol-lowering injections alirocumab, was FDA approved in July 2015 for use as an adjunct treatment, with maximally tolerated statin therapy, for heterozygous familial hypercholesterolemia. A leading cause of mortality in the United States is associated with high risk of adverse coronary events such as myocardial infarction and stroke. The objective of this study is to review current literature to determine the cost-effectiveness of alirocumab in the treatment of hypercholesterolemia.

METHODS: To create a thorough analysis of the available literature, databases including PubMed, Medline and Google Scholar were searched. Utilizing key words such as ‘alirocumab’, ‘LDL-cholesterol’, ‘hypercholesterolemia’, and ‘cost-effectiveness’ generated 65 relevant articles. The search was further refined to include articles that met our inclusion criteria of a patient population age 18 and older with an LDL level > RESULTS: An updated analysis completed by the Institute for Clinical and Economic Review examined the cost-effectiveness of alirocumab based on the ODYSSEY outcomes trial. The cost effectiveness was illustrated in terms of cost per additional quality-adjusted life year (QALY) added for treatment with alirocumab + statin paralleled with statin alone among patients who meet the inclusion criteria of the ODYSSEY Outcomes Trial. The cost effectiveness of alirocumab is patient specific. According to ICER, the drug would be the most cost-effective in patients who have a baseline LDL-C > 100mg/dL compared to the maximal statin therapy.

CONCLUSIONS: Consistently throughout the efficacy trials, alirocumab was found to yield a greater reduction in LDL-C levels when compared to statin and/or ezetimibe therapy. This suggests that the application of alirocumab into health care practices will produce significant benefits in the management of hypercholesterolemia.