Cost-effectiveness of low-dose colchicine in patients with chronic coronary disease in The Netherlands.

IF 4.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS European Heart Journal - Quality of Care and Clinical Outcomes Pub Date : 2025-01-16 DOI:10.1093/ehjqcco/qcae021

Aernoud T L Fiolet, Willem Keusters, Johan Blokzijl, S Mark Nidorf, John W Eikelboom, Charley A Budgeon, Jan G P Tijssen, Tjeerd Römer, Iris Westendorp, Jan Hein Cornel, Peter L Thompson, Geert W J Frederix, Arend Mosterd, G Ardine de Wit

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Abstract

Aims: Recent trials have shown that low-dose colchicine (0.5 mg once daily) reduces major cardiovascular events in patients with acute and chronic coronary syndromes. We aimed to estimate the cost-effectiveness of low-dose colchicine therapy in patients with chronic coronary disease when added to standard background therapy.

Methods and results: This Markov cohort cost-effectiveness model used estimates of therapy effectiveness, transition probabilities, costs, and quality of life obtained from the Low-Dose Colchicine 2 trial, as well as meta-analyses and public sources. In this trial, low-dose colchicine was added to standard of care and compared with placebo. The main outcomes were cardiovascular events, including myocardial infarction, stroke, and coronary revascularization, quality-adjusted life year (QALY), the cost per QALY gained (incremental cost-effectiveness ratio), and net monetary benefit. In the model, low-dose colchicine therapy yielded 0.04 additional QALYs compared with standard of care at an incremental cost of €455 from a societal perspective and €729 from a healthcare perspective, resulting in a cost per QALY gained of €12 176/QALY from a societal perspective and €19 499/QALY from a healthcare perspective. Net monetary benefit was €1414 from a societal perspective and €1140 from a healthcare perspective. Low-dose colchicine has a 96 and 94% chance of being cost-effective, from a societal and a healthcare perspective, respectively, when using a willingness to pay of €50 000/QALY. Net monetary benefit would decrease below zero when annual low-dose colchicine costs would exceed an annual cost of €221 per patient.

Conclusion: Adding low-dose colchicine to standard of care in patients with chronic coronary disease is cost-effective according to commonly accepted thresholds in Europe and Australia and compares favourably in cost-effectiveness to other drugs used in chronic coronary disease.

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荷兰慢性冠心病患者服用小剂量秋水仙碱的成本效益。

目的：最近的试验表明，小剂量秋水仙碱（0.5 毫克，每日一次）可减少急性和慢性冠状动脉综合征患者的主要心血管事件。我们旨在估算慢性冠心病患者在接受标准背景治疗的同时接受小剂量秋水仙碱治疗的成本效益：该马尔可夫队列成本效益模型使用了低剂量秋水仙碱 2（LoDoCo2）试验以及荟萃分析和公开资料中对治疗效果、转换概率、成本和生活质量的估计。在该试验中，低剂量秋水仙碱被添加到标准治疗中，并与安慰剂进行比较。主要结果是心血管事件（包括心肌梗死、中风和冠状动脉血运重建）、质量调整生命年（QALY）、每获得 QALY 的成本（增量成本效益比）和净货币收益。在模型中，与标准治疗相比，小剂量秋水仙碱治疗可增加 0.04 个质量调整生命年，从社会角度看，增量成本为 455 欧元，从医疗角度看，增量成本为 729 欧元，因此，从社会角度看，每获得一个质量调整生命年的成本为 12,176 欧元/质量调整生命年，从医疗角度看，每获得一个质量调整生命年的成本为 19,499 欧元/质量调整生命年。从社会角度看，净货币收益为 1,414 欧元，从医疗角度看为 1,140 欧元。如果采用 50,000 欧元/QALY 的支付意愿，从社会和医疗角度来看，小剂量秋水仙碱具有成本效益的几率分别为 96% 和 94%。当小剂量秋水仙碱的年成本超过每位患者 221 欧元的年成本时，净货币效益将降至零以下：结论：根据欧洲和澳大利亚普遍接受的阈值，在慢性冠心病患者的标准治疗中添加小剂量秋水仙碱具有成本效益，与其他用于慢性冠心病的药物相比，其成本效益更胜一筹。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Heart Journal - Quality of Care and Clinical Outcomes CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

9.40

自引率

3.80%

发文量

期刊介绍： European Heart Journal - Quality of Care & Clinical Outcomes is an English language, peer-reviewed journal dedicated to publishing cardiovascular outcomes research. It serves as an official journal of the European Society of Cardiology and maintains a close alliance with the European Heart Health Institute. The journal disseminates original research and topical reviews contributed by health scientists globally, with a focus on the quality of care and its impact on cardiovascular outcomes at the hospital, national, and international levels. It provides a platform for presenting the most outstanding cardiovascular outcomes research to influence cardiovascular public health policy on a global scale. Additionally, the journal aims to motivate young investigators and foster the growth of the outcomes research community.