The Value of Atorvastatin Over the Product Life Cycle in the United States

Do Value Thresholds for Oncology Drugs Differ from Nononcology Drugs?

“…Standard care 190,000 (low risk with uterus) 100,000 72,000 (low risk without uterus) 57,000 (high risk with uterus) 37,000 (high risk without uterus) Breast cancer 20 Adjuvant trastuzumab Standard care 39,000 N/A Breast cancer 21 Anastrozole Tamoxifen 26 OnabotulinumtoxinA Best supportive care 24,000 N/A Knee osteoarthritis 27 Disease-modifying osteoarthritis drugs Standard care 57,000 N/A Chronic low back pain 28 Duloxetine Naproxen 59,473 N/A Human immunodeficiency virus 29 Generic-based antiretroviral therapy No antiretroviral therapy 21,000 100,000 Branded antiretroviral therapy Generic-based antiretroviral therapy 114,000 Type 2 diabetes 30 Exenatide Insulin glargine 15,000 N/A ADHD 31 Guanfacine XR + stimulant Stimulant monotherapy 31,000 50,000 Anticoagulation in cancer patients 32 Low molecular-weight heparin No prophylaxis 90,893 N/A Stroke prevention in atrial fibrillation 33 Rivaroxaban Warfarin 27,000 100,000 Multiple sclerosis 34 Fingolimod IFN beta-1a 73,000 100,000 S. aureus vaccine in hemodialysis patients 35 Vaccine (1% colonization rate) No vaccine 25,217 N/A Schizophrenia 36 Olanzapine ODT SOT 19,000 N/A Olanzapine ODT Risperidone SOT 39,000 End-stage renal disease 37 Erythropoietin stimulating agents Routine blood transfusions 873 N/A Hyperlipidemia 38 Atorvastatin Simvastatin 45,000 N/A Acute coronary syndrome 39 Ticagrelor Genotype-driven treatment 10,000 50,000 Human immunodeficiency virus 40 Atazanavir -ritonavir Lopinavir -ritonavir 26,000 50,000 Type 2 diabetes 41 Liraglutide Exenatide 40,000 N/A Human immunodeficiency virus 42 Darunavir -ritonavir Lopinavir -ritonavir 23,000 N/A Macular degeneration 43 Bevacizumab Ranibizumab -54,000 N/A Cardiovascular disease 44 Rosuvastatin (20-year horizon) Placebo 10,000 N/A Rosuvastatin (10-year horizon) 44 …”

PARADIGM‐HF Trial: Secondary Analyses Address Unanswered Questions

“…At a WTP of $50,000, the model was cost‐effective in 57% of simulations versus 80% when the WTP was raised to $100,000 per QALY . For comparison, the ICER for atorvastatin was approximately $45,000 per QALY gained versus $120,000–$300,000 for left ventricular assist devices . Reducing the cost of enalapril from the Red Book price to a standard $10 per 90‐day supply only marginally impacted the ICER; however, when assuming future generic costs for sacubitril/valsartan, ICER is reduced to approximately $27,382–$43,808 .…”

“…23 For comparison, the ICER for atorvastatin was approximately $45,000 per QALY gained versus $120,000-$300,000 for left ventricular assist devices. 26,27 Reducing the cost of enalapril from the Red Book price to a standard $10 per 90-day supply only marginally impacted the ICER; however, when assuming future generic costs for sacubitril/valsartan, ICER is reduced to approximately $27,382-$43,808. 23 Based on discretionary WTP, this model demonstrated that the use of sacubitril/valsartan could be cost-effective.…”

The Health Impact Fund: How Might It Work for Novel Anticoagulants in Atrial Fibrillation?

“…In the last 3 years, following successful phase 3 clinical trials, three agents(dabigatran, apixaban and rivaroxaban) have been incorporated into guidelines worldwide and more NOACs are in the pipeline [38][39][40] . As with statins, ACEIs, ARBs and other CVD drug classes, "me-too" agents are anticipated and trials are already underway [41][42][43][44] . "Me-too" drugs are expensive and do not serve society well [41][42][43] .…”

“…As with statins, ACEIs, ARBs and other CVD drug classes, "me-too" agents are anticipated and trials are already underway [41][42][43][44] . "Me-too" drugs are expensive and do not serve society well [41][42][43] . The HIF may combine profits with patient benefit in a mutually beneficial manner.…”