CHDS faculty Ankur Pandya and affiliate Jinyi Zhu discussed the cost-effectiveness of using apolipoprotein B (apoB), non–high-density lipoprotein cholesterol (non–HDL-C), or low-density lipoprotein cholesterol (LDL-C) goals to guide statin intensification in a JAMA opinion editorial.
The authors discussed a simulation model–based cost-effectiveness analysis by Luebbe and colleagues that compared lifetime health and cost outcomes for the three biomarker-guided strategies. In that analysis, the apoB strategy produced the most quality-adjusted life-years at the highest expected cost. The non–HDL-C strategy was cost-saving compared with usual care based on LDL-C, while the apoB strategy had an incremental cost-effectiveness ratio of $30,300 per quality-adjusted life-year compared with non–HDL-C. The apoB strategy was optimal in 65% of probabilistic sensitivity-analysis iterations at a threshold of $120,000 per quality-adjusted life-year.
The authors noted that additional evidence in lower-risk populations and information about clinical feasibility would be needed to determine whether broader statin intensification should inform future guideline recommendations.
Learn more: Read the opinion editorial, ApoB and Resilient Cost-Effectiveness of Statin Intensity
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