ArticleClinical kidney journal2022
Trimming the fat: is there a health economic case for the use of new lipid-lowering drugs in chronic kidney disease? A scoping review.
Article in Clinical kidney journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Individuals with chronic kidney disease (CKD) are at a very high risk for atherosclerotic cardiovascular disease (ASCVD). New lipid-lowering agents offer hope of improved outcomes where traditional agents have been less efficacious, yet the cost of these agents needs consideration in this population before their widespread application. Objective: We sought to evaluate the cost-effectiveness of novel lipid-lowering therapies for a CKD population. Methods: We searched four electronic databases, one government registry and the reference lists of included literature to identify cost-effectiveness analyses of novel lipid-lowering agents in CKD. Costs were converted to a single currency to allow cross-country comparisons. Completeness of reporting was analysed using the Consolidated Health Economic Evaluation Reporting Standards checklist. Results were synthesized in narrative form with graphical representation of cost-effectiveness ratios. Results: Of the 1041 identified studies, 4 met the inclusion criteria. None were specific to a CKD-only population. All examined the impact of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) in the secondary prevention of ASCVD. Incremental cost-effectiveness ratios of new agents compared with standard care were between €7288 and €112 530 per quality-adjusted life year gained. Cost-effectiveness was sensitive to the degree of cardiovascular risk of the underlying populations. Conclusion: This review found PCSK9is were moderately cost-effective in populations with high cardiovascular risk. People with CKD were included as an undifferentiated subpopulation in the primary studies, but application of these findings to CKD-specific populations should be interpreted with caution. There is insufficient evidence for a health economic case to support novel lipid-lowering therapies for advanced CKD.
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