The Hurdle of Access to Emerging Therapies and Potential Solutions in the Management of Dyslipidemias

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(14), P. 4160 - 4160

Published: July 16, 2024

This review explores the many barriers to accessing lipid-lowering therapies (LLTs) for prevention and management of atherosclerotic cardiovascular disease (ASCVD). Geographical, knowledge, regulatory significantly impede access LLTs, exacerbating disparities in healthcare infrastructure affordability. We highlight importance policy reforms, including pricing regulations reimbursement policies, enhancing affordability streamlining processes. Innovative funding models, such as value-based outcome-based payment arrangements, have been recommended make novel LLTs more accessible. Public health interventions, community-based programs telemedicine, can be utilized reach underserved populations improve medication adherence. Education advocacy initiatives led by patient groups providers play a crucial role raising awareness empowering patients. Despite access, present big opportunity reduce burden ASCVD, emphasizing need collaborative efforts among policymakers, providers, industry stakeholders, address these globally.

Language: Английский

---

Perspectives on early health economic evaluations of RNA therapies targeted at lipoprotein(a)

Current Opinion in Endocrinology Diabetes and Obesity, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 12, 2025

Purpose of review Early health economic evaluations new medications are useful, as they consider the implications for services. We reviewed recent literature on expected clinical outcomes lowering elevated plasma lipoprotein(a) [Lp(a)] in secondary prevention, which is essential information effectiveness evaluations. a early evaluation RNA therapies targeted at Lp(a). Recent findings RNA-based therapies, if approved, would likely be used initially adults with established atherosclerotic cardiovascular disease (ASCVD) and very high Adults ASCVD have absolute risk recurrent events Lp(a) serves risk-enhancing factor. Potent prevention may associated significant relative reductions coronary heart or events; this needs confirmation currently ongoing future trials. One has estimated value olpasiran pelacarsen, various willingness-to-pay thresholds, compared standard-of-care prevention. Summary estimate longer-term benefits cost consequences medications. Existing casual evidence can best available evidence, while awaiting results from major

Language: Английский

---

A Review of Heterogeneity in Comparative Economic Analysis, with Specific Considerations for the Decentralized US Setting and Patient-Centered Care

PharmacoEconomics, Journal Year: 2025, Volume and Issue: unknown

Published: March 8, 2025

Patient-centered care emphasizes individual preferences, but insurer coverage decisions—based on population-level evidence—may restrict treatment options for patients who differ from the average. This highlights importance of considering heterogeneity, which refers to differences in health and cost outcomes that are systematically linked variations factors like patient characteristics, policies, provider practices. Failing account heterogeneity economic evaluations can lead suboptimal decisions, inferior outcomes, inefficiency. study aimed assess tools methods addressing evaluations, examine extent which, how, has been addressed US cost-utility studies, provide insights recommendations promote more fuller consideration evaluations. We reviewed adapted a seminal taxonomy setting, highlighting key drivers preferences insurance design. Methods were also summarized. used data Tufts Medical Center Cost-Effectiveness Analysis Registry empirical practices applications, specifically frequency, types, impact subgroup analysis, whether rationales including or excluding subgroups provided. The revised diverse decentralized healthcare ecosystem, such as diversity non-patient access providers coverage. explore, confirm, incorporate into comparative analysis exist, often challenged by availability. In addition trade-off between potential efficiency gains increasing uncertainty value estimates, ethical implications stratified decisions highlighted literature. found was rare, primarily performed clinical age disease severity. Only 2 85 studies published 2015 2022 with subgroup-level results consider factors, none considered preferences. One-third reported incremental cost-effectiveness ratios differing than 50% unstratified estimate. No provided rationale omitting only two motivated inclusion limiting our ability appropriateness these decisions. Despite well-documented address its application is limited especially regarding factors. As drive real-world costs USA, proper of, reporting on, essential avoid erroneous market Future efforts, work an upcoming Professional Society Pharmacoeconomics Outcomes Research Task Force, should continue refine taxonomies emphasize heterogeneity.

Language: Английский

---

Current and Future Cost Burden of Ischemic Stroke in Australia: Dynamic Model

Neuroepidemiology, Journal Year: 2024, Volume and Issue: 58(5), P. 358 - 368

Published: April 1, 2024

Stroke remains one of the leading causes morbidity and mortality in Australia. The objective this study was to estimate current future cost burden ischemic stroke (IS)

Language: Английский

---

Are We Using Ezetimibe As Much As We Should?

Biomarker Insights, Journal Year: 2024, Volume and Issue: 19

Published: Jan. 1, 2024

Lipid-lowering therapies, particularly non-statin regimens, are underutilized as ~2/3 of patients with atherosclerotic cardiovascular (CV) disease (CVD) not optimally managed, and do attain target low-density lipoprotein cholesterol (LDL-C) concentrations, despite statin treatment. Statins have been the mainstay hypolipidemic therapies; however, they plagued by adverse effects, which partly hindered their more widespread use. Ezetimibe is often first added mode treatment to LDL-C goals it efficacious also allows use a smaller dose statin, while need for expensive therapies obviated. We herein provide comprehensive review effects ezetimibe in lipid lowering reducing CV events improving outcomes. Of oral ezetimibe, contrast newer agents, most convenient and/or affordable regimen be utilized mono- or combined therapy supported data from outcomes studies attesting its efficacy CVD risk events. When could lower, thus curtailing side-effects, effect enhanced (by ~20%) percentage level (<70 mg/dL) higher versus high-intensity statin. serve an alternative cases intolerance. In conclusion, has excellent safety/tolerability profile; that can targets. therapy, limiting occurrence side-effects.

Language: Английский

---

A Causal Model for Primary Prevention of Cardiovascular Disease: The Health Economic Model for the Primary Prevention of Cardiovascular Disease

Value in Health, Journal Year: 2024, Volume and Issue: unknown

Published: July 1, 2024

Our objective was to design and develop an open-source model capable of simulating interventions for primary prevention cardiovascular disease (CVD) that incorporated the cumulative effects risk factors (eg, cholesterol years or blood-pressure years) enhance health economic modeling in settings which clinical trials are not possible.

Language: Английский

---

Health economics of detection and treatment of children with familial hypercholesterolemia: to screen or not to screen is no longer the question

Current Opinion in Endocrinology Diabetes and Obesity, Journal Year: 2023, Volume and Issue: 31(2), P. 84 - 89

Published: Nov. 20, 2023

Heterozygous familial hypercholesterolemia (HeFH) is one of the most common monogenic disorders and safely treatable with lipid-lowering medication. However, individuals HeFH remain untreated undetected, especially in paediatric populations where potential for long-term therapeutic benefit higher. Here, we review recent literature on health economic outcomes detection management FH children.

Language: Английский

---

Promoting Heart Health: Raising Screening Awareness at a Brisbane Medical Center

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: June 11, 2024

Background Atherosclerotic cardiovascular disease (CVD) is a largely preventable, chronic, and progressive medical condition. There appears to be general lack of knowledge about CVD prevention in the community. This pilot study was carried out investigate level among patients visiting practitioner (GP) practice Brisbane. Aim To people local clinic Brisbane, identify factors responsible for any deficits. Material methods A cross-sectional survey conducted Brisbane residents aged 45 years older center. surveyed 105 Australian individuals via an online or hard copy questionnaire those without access. combination closed-ended questions multiple-choice questionnaires utilized collect data. Questions were formulated assess this demographic, exploring subjects' awareness screening program, their adherence, behind non-adherence, understanding influence education occupation on adherence. Results total adults completed survey, which 56 (53.3%) male. The found that 61 (58.1%) participants aware but only 22 (21.9%) compliant with it. Twelve (11.4%) attended these preventive screenings less frequently than recommended, while remaining 69 (66.6%) had never undergone health checks. Conclusion Analysis data from population suggests there deficit regarding programs. Enhanced efforts by clinicians make tools employ early intervention strategies, especially lifestyle choices at earlier age, would help lower burden CVD.

Language: Английский

---

Aggressive low-density lipoprotein (LDL) lowering for primary prevention: still an elusive goal

Lipids in Health and Disease, Journal Year: 2024, Volume and Issue: 23(1)

Published: Sept. 6, 2024

Language: Английский

---

Moderate-Intensity Statin Plus Ezetimibe: Time to Rethink it as an Optimal Initial Lipid-Lowering Strategy

Drugs, Journal Year: 2024, Volume and Issue: 85(1), P. 51 - 65

Published: Nov. 14, 2024

Achievement of low-density lipoprotein cholesterol (LDL-C) targets is crucial for the prevention cardiovascular disease (CVD) in individuals with dyslipidaemia who are at high risk. Current guidelines recommend high-intensity statins highest tolerated dose as initial treatment to achieve LDL-C goals. However, real-world situation dismal: underused and achievement goals suboptimal. Various challenges exist implementation recommended strategy, including hesitancy use statins, non-adherence, side effects, response varies across individuals. Emerging studies have shown another line lipid-lowering, moderate-intensity combination ezetimibe, presenting considerable efficacy/effectiveness, along better safety adherence compared statin intensification alone. Here we review clinical evidence, associated summarise evidence on therapy, plus which core strategy by 2023 Chinese Guideline Lipid Management, a possible primary several populations. The upfront ezetimibe may improve control lead CVD settings.

Language: Английский

---