Impact of China’s Low Centralized Medicine Procurement Prices on the Cost-Effectiveness of Statins for the Primary Prevention of Atherosclerotic Cardiovascular Disease
Background: Statin medications reduce the risk of atherosclerotic cardiovascular disease (ASCVD). China’s new central government medicine procurement policy lowered statin prices by five-fold or more, which may impact the cost-effectiveness of statin therapy. Objective: To explore the impact of Chin...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Ubiquity Press
2020-06-01
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| Series: | Global Heart |
| Subjects: | |
| Online Access: | https://globalheartjournal.com/articles/830 |
| _version_ | 1811331621792514048 |
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| author | Miao Wang Jing Liu Brandon K. Bellows Yue Qi Jiayi Sun Jun Liu Andrew E. Moran Dong Zhao |
| author_facet | Miao Wang Jing Liu Brandon K. Bellows Yue Qi Jiayi Sun Jun Liu Andrew E. Moran Dong Zhao |
| author_sort | Miao Wang |
| collection | DOAJ |
| description | Background: Statin medications reduce the risk of atherosclerotic cardiovascular disease (ASCVD). China’s new central government medicine procurement policy lowered statin prices by five-fold or more, which may impact the cost-effectiveness of statin therapy. Objective: To explore the impact of China’s 2019 centralized medicine procurement policy on the cost-effectiveness of statins treatment for primary ASCVD prevention. Methods: A microsimulation decision tree analytic model was built using individual participant data from ASCVD-free adults aged 35–64 years (n = 21,265) in the China Multi-provincial Cohort Study. ASCVD incidence, costs (2019 Int$), and quality-adjusted life years (QALYs) over a 10-year period from health-care sector and societal perspectives were estimated. Effect and cost-effectiveness of low-dose statins (equivalent potency regimens of simvastatin 20 mg/day, atorvastatin 10 mg/day, or rosuvastatin 5 mg/day) and moderate-dose (double low dose) statins therapy were simulated. The incremental cost-effectiveness ratio (ICER) of statin treatment was compared with no treatment by category of 10-year ASCVD risk. New lower prices of statins were from the centralized procurement policy bid-winning announcement file. One-way and probabilistic sensitivity analyses quantified model uncertainty. Results: Low-dose statins interventions reduced 10-year ASCVD incidence by 4.1%, 9.7%, and 15.5% among people with low, moderate, and high risk comparing to no treatment. Lowering statin prices to the 2019 central government procurement policy level could lower the ICER of low-dose statins treatment for high-risk people from Int$ 141,000 to Int$ 51,300 per QALY gained from health-care sector perspective. Moderate-dose statin treatment lowered the ICER compared with the low-dose statins treatment in each ASCVD risk category (Int$ 43,100 vs. Int$ 51,300 per QALY gained from the health-care sector perspective for high risk people). Cost-effectiveness improved progressively with increased baseline ASCVD risk. Conclusion: Implementing low central government prices will substantially improve the cost-effectiveness of statins for primary ASCVD prevention in 35–64-year-old Chinese adults. |
| first_indexed | 2024-04-13T16:23:26Z |
| format | Article |
| id | doaj.art-d38f799fac674c3c9c19053d8a64c327 |
| institution | Directory Open Access Journal |
| issn | 2211-8179 |
| language | English |
| last_indexed | 2024-04-13T16:23:26Z |
| publishDate | 2020-06-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Global Heart |
| spelling | doaj.art-d38f799fac674c3c9c19053d8a64c3272022-12-22T02:39:49ZengUbiquity PressGlobal Heart2211-81792020-06-0115110.5334/gh.830774Impact of China’s Low Centralized Medicine Procurement Prices on the Cost-Effectiveness of Statins for the Primary Prevention of Atherosclerotic Cardiovascular DiseaseMiao Wang0Jing Liu1Brandon K. Bellows2Yue Qi3Jiayi Sun4Jun Liu5Andrew E. Moran6Dong Zhao7Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing; The Beijing Municipal Key Laboratory of Clinical Epidemiology, BeijingDepartment of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing; The Beijing Municipal Key Laboratory of Clinical Epidemiology, BeijingDivision of General Medicine, Department of Medicine, Columbia University, New YorkDepartment of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing; The Beijing Municipal Key Laboratory of Clinical Epidemiology, BeijingDepartment of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing; The Beijing Municipal Key Laboratory of Clinical Epidemiology, BeijingDepartment of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing; The Beijing Municipal Key Laboratory of Clinical Epidemiology, BeijingDivision of General Medicine, Department of Medicine, Columbia University, New YorkDepartment of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing; The Beijing Municipal Key Laboratory of Clinical Epidemiology, BeijingBackground: Statin medications reduce the risk of atherosclerotic cardiovascular disease (ASCVD). China’s new central government medicine procurement policy lowered statin prices by five-fold or more, which may impact the cost-effectiveness of statin therapy. Objective: To explore the impact of China’s 2019 centralized medicine procurement policy on the cost-effectiveness of statins treatment for primary ASCVD prevention. Methods: A microsimulation decision tree analytic model was built using individual participant data from ASCVD-free adults aged 35–64 years (n = 21,265) in the China Multi-provincial Cohort Study. ASCVD incidence, costs (2019 Int$), and quality-adjusted life years (QALYs) over a 10-year period from health-care sector and societal perspectives were estimated. Effect and cost-effectiveness of low-dose statins (equivalent potency regimens of simvastatin 20 mg/day, atorvastatin 10 mg/day, or rosuvastatin 5 mg/day) and moderate-dose (double low dose) statins therapy were simulated. The incremental cost-effectiveness ratio (ICER) of statin treatment was compared with no treatment by category of 10-year ASCVD risk. New lower prices of statins were from the centralized procurement policy bid-winning announcement file. One-way and probabilistic sensitivity analyses quantified model uncertainty. Results: Low-dose statins interventions reduced 10-year ASCVD incidence by 4.1%, 9.7%, and 15.5% among people with low, moderate, and high risk comparing to no treatment. Lowering statin prices to the 2019 central government procurement policy level could lower the ICER of low-dose statins treatment for high-risk people from Int$ 141,000 to Int$ 51,300 per QALY gained from health-care sector perspective. Moderate-dose statin treatment lowered the ICER compared with the low-dose statins treatment in each ASCVD risk category (Int$ 43,100 vs. Int$ 51,300 per QALY gained from the health-care sector perspective for high risk people). Cost-effectiveness improved progressively with increased baseline ASCVD risk. Conclusion: Implementing low central government prices will substantially improve the cost-effectiveness of statins for primary ASCVD prevention in 35–64-year-old Chinese adults.https://globalheartjournal.com/articles/830cardiovascular diseasecost-effectivenesslow-density lipoprotein cholesterolmicrosimulationprimary preventionstatins |
| spellingShingle | Miao Wang Jing Liu Brandon K. Bellows Yue Qi Jiayi Sun Jun Liu Andrew E. Moran Dong Zhao Impact of China’s Low Centralized Medicine Procurement Prices on the Cost-Effectiveness of Statins for the Primary Prevention of Atherosclerotic Cardiovascular Disease Global Heart cardiovascular disease cost-effectiveness low-density lipoprotein cholesterol microsimulation primary prevention statins |
| title | Impact of China’s Low Centralized Medicine Procurement Prices on the Cost-Effectiveness of Statins for the Primary Prevention of Atherosclerotic Cardiovascular Disease |
| title_full | Impact of China’s Low Centralized Medicine Procurement Prices on the Cost-Effectiveness of Statins for the Primary Prevention of Atherosclerotic Cardiovascular Disease |
| title_fullStr | Impact of China’s Low Centralized Medicine Procurement Prices on the Cost-Effectiveness of Statins for the Primary Prevention of Atherosclerotic Cardiovascular Disease |
| title_full_unstemmed | Impact of China’s Low Centralized Medicine Procurement Prices on the Cost-Effectiveness of Statins for the Primary Prevention of Atherosclerotic Cardiovascular Disease |
| title_short | Impact of China’s Low Centralized Medicine Procurement Prices on the Cost-Effectiveness of Statins for the Primary Prevention of Atherosclerotic Cardiovascular Disease |
| title_sort | impact of china s low centralized medicine procurement prices on the cost effectiveness of statins for the primary prevention of atherosclerotic cardiovascular disease |
| topic | cardiovascular disease cost-effectiveness low-density lipoprotein cholesterol microsimulation primary prevention statins |
| url | https://globalheartjournal.com/articles/830 |
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