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Atherosclerosis III: Management01:26

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Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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相关实验视频

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A High-Throughput Luciferase Assay to Evaluate Proteolysis of the Single-Turnover Protease PCSK9
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在异卵性家族高胆固醇血症或动脉样性心血管疾病患者中使用PCSK9抑制剂治疗的成本效益

Dhruv S Kazi1, Andrew E Moran2, Pamela G Coxson3

  • 1Department of Medicine, Center for Vulnerable Populations, University of California, San Francisco2Department of Medicine, University of California, San Francisco3Department of Epidemiology and Biostatistics, University of California, San Francisco4Center.

JAMA
|August 18, 2016
PubMed
概括

在目前的价格下,治疗家族性高胆固醇血症 (FH) 和动脉样性心血管疾病 (ASCVD) 的PCSK9抑制剂不具有成本效益. 需要大幅降低药品成本以达到成本效益的门,避免增加美国的整体医疗支出.

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科学领域:

  • 心血管医学
  • 健康经济学
  • 药物经济学

背景情况:

  • 蛋白转化酶9型 (PCSK9) 抑制剂有可能预防动脉样硬化心血管疾病 (ASCVD).
  • PCSK9抑制剂的成本效益和对医疗保健支出的影响仍然不确定.

研究的目的:

  • 估计PCSK9抑制剂的成本效益.
  • 评估PCSK9抑制剂对美国医疗保健支出的潜在影响.

主要方法:

  • 一个模拟模型 (心血管疾病政策模型) 评估了35至94岁的异性家族高胆固醇血症 (FH) 或ASCVD的成年人的成本效益.
  • 该模型结合了2015年PCSK9抑制剂的成本 (每年14,350美元),健康系统的视角和终身水平.
  • 为了解决不确定性,进行了概率敏感性分析.

主要成果:

  • 在FH中,将PCSK9抑制剂添加到他类药物中,每增加的质量调整寿命年 (QALY) 需要503,000美元.
  • 在ASCVD中,将PCSK9抑制剂添加到他类药物中,每次QALY的成本为414,000美元.
  • 根据2015年的价格,使用PCSK9抑制剂预计将使药物成本在5年内增加5920亿美元,尽管心血管护理成本减少了290亿美元.

结论:

  • 以2015年价格使用PCSK9抑制剂不符合FH或ASCVD的成本效益值,并大大增加了美国的医疗成本.
  • 每年的药费必须降至4,536美元或更低才能达到每QALY100,000美元的门.
  • 在符合条件的人群中开始服用他类药物预计将节省120亿美元.