Cost-utility analysis of evolocumab in patients with ASCVD in Italy


  • Andrea Marcellusi Faculty of Economics, Economic Evaluation and HTA (EEHTA), CEIS, University of Rome “Tor Vergata”, Rome - Italy and Institute for Leadership and Management in Health - Kingston University London, London - UK
  • Chiara Bini Faculty of Economics, Economic Evaluation and HTA (EEHTA), CEIS, University of Rome “Tor Vergata”, Rome - Italy
  • Maria Assunta Rotundo Faculty of Economics, Economic Evaluation and HTA (EEHTA), CEIS, University of Rome “Tor Vergata”, Rome - Italy
  • Emanuela Arcangeli Value & Access Department Italy, Amgen Srl, Milan - Italy
  • Laura Martinez AMGEN Europe, Rotkreuz - Switzerland
  • Francesc Sorio Vilela AMGEN Europe, Rotkreuz - Switzerland
  • Francesco Saverio Mennini Faculty of Economics, Economic Evaluation and HTA (EEHTA), CEIS, University of Rome “Tor Vergata”, Rome - Italy and Institute for Leadership and Management in Health - Kingston University London, London - UK



Cardiovascular disease, PCSK9 inhibitors


Objective: The aim of this work was to evaluate the cost-effectiveness of evolocumab in addition to standard statin therapy with or without ezetimibe in the treatment of patients with clinically evident atherosclerotic cardiovascular disease (ASCVD) with levels of LDL-C above 100 mg/dL.

Method: A theoretical cohort of patients was forecast by a Markov model that includes 11 health states for a lifetime horizon. In the base-case, the standard therapy was characterized by statins with or without ezetimibe. Two sub-populations have been considered, Recent MI (Myocardial Infarction in the last year) and Multiple events (population with multiple MI). The results were also presented for a subset of the Multiple events populations consisting of patients who have experienced a myocardial infarction (MI) in the last year.

Results: For the Recent MI and Multiple events populations, ICER values of € 39,547 and € 35,744 respectively were estimated. The value of ICER was lower for the Multiple events with MI < 1 year population (€ 29,949). Considering statins with ezetimibe as standard therapy, ICER values were found to be equal to € 39,781, € 35,986 and € 30,190 respectively for the populations Recent MI, Multiple events and Multiple events with MI < 1 year.

Conclusions: The estimated ICER values for the Recent MI, Multiple events and Multiple events populations with MI < 1 year were below the cost-effectiveness threshold of € 40,000, suggesting therefore how the treatment with evolocumab in addition to the standard therapy can be a cost-effective treatment both compared to standard therapy with statins and standard therapy with statins + ezetimibe.


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How to Cite

Marcellusi, A., Bini, C., Rotundo, M. A., Arcangeli, E., Martinez, L., Sorio Vilela, F., & Mennini, F. S. (2021). Cost-utility analysis of evolocumab in patients with ASCVD in Italy. Global and Regional Health Technology Assessment, 8(1), 155–167.



Original Research Articles


Received 2021-03-04
Accepted 2021-07-20
Published 2021-11-02


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