TABLE 3.
Scenario analyses.
| Effect based on HRs of clinical endpoints | Effect based on RRs of LDL-C reduction | |||||
|---|---|---|---|---|---|---|
| Treatment alternative | ICER, CNY | VBP, CNY a | ICER, CNY | VBP, CNY a | ||
| Discounted net price | Full list price | Discounted net price | Full list price | |||
| Hypothesis of efficacy | ||||||
| Reduction in non-cardiovascular death | 1,032,482 | 1,577,392 | 8,513 | 860,508 | 1,323,098 | 10,300 |
| Intervention therapy strategy | ||||||
| Ezetimibe added to statins therapy group | 6,564,056 b | 10,185,808 b | 4232 b | 1,229,700 | 1,953,885 | 10,232 |
| Different subgroups | ||||||
| Female population | 1,777,745 | 2,722,174 | 5,890 | 858,907 | 1,348,791 | 11,696 |
| FH With MI | NA | NA | NA | 254,945 | 433,970 | 30,299 |
| Polyvascular disease (3 beds) | 111,750 | 217,596 | 50,734 c | NA | NA | NA |
| DM with MI | 1,364,704 | 2,092,499 | 7,165 | 673,573 | 1,061,929 | 13,970 |
| Hypertension with MI | 1,498,227 | 2,292,296 | 6,546 | 746,873 | 1,171,640 | 12,753 |
| Starting age | ||||||
| 65 years | 1,412,372 | 2,162,769 | 6,893 | 697,772 | 1,097,287 | 13,498 |
| 70 years | 1,263,829 | 1,939,951 | 7,650 | 621,794 | 983,866 | 14,946 |
| 75 years | 1,107,200 | 1,705,199 | 8,661 | 535,187 | 854,940 | 17,030 |
| 80 years | 842,649 | 1,308,215 | 11,112 | 394,518 | 644,888 | 21,879 |
| Time horizon | ||||||
| 5 years | 4,849,493 | 7,314,287 | 2041 | 2,601,645 | 3,950,287 | 3,928 |
| 10 years | 2,606,179 | 3,947,808 | 3,711 | 1,375,241 | 2,107,685 | 7,091 |
| 20 years | 1,634,778 | 2,493,198 | 5,899 | 830,503 | 1,292,466 | 11,383 |
| 30 years | 1,721,959 | 2,630,181 | 5,810 | 854,582 | 1,335,577 | 11,432 |
| Discount rate | ||||||
| 3.5% | 1,551,023 | 2,371,171 | 6,325 | 769,471 | 1,204,852 | 12,388 |
| 6% | 1,659,693 | 2,533,180 | 5,900 | 831,970 | 1,297,604 | 11,510 |
CNY, Chinese Yuan; DM, diabetes mellitus; FH, familial hypercholesterolemia; HR, hazard ratio; ICER, incremental cost-effectiveness ratio; LDL-C, low-density lipoprotein cholesterol; MI, myocardial infarction; NA, not applicable; RR, relative risk; VBP, value-based price.
a
VBP was defined as an estimated expected price to meet the ICER of 212,676 CNY per QALY gained.
b
The effect of ezetimibe was modeled by integrating the clinical follow-up efficacy on non-fatal events and the assumed LDL-C reduction efficacy on cardiovascular death.
c
The discounted net price of alirocumab has achieved the willingness-to-pay threshold and a small reduction from the full list price was recommended.