Estimation of Eligibility for PCSK9 Inhibitors and Associated Costs Based on the FOURIER Trial: Insights from the Department of Veterans Affairs
In the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) trial,1 treatment with evolocumab resulted in a 15% relative (1.5% absolute) risk reduction of major cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD) at a median follow-up of 2.2 years. This trial included patients with LDL-C≥70mg/dL or non-HDL-C ≥100mg/dL on at least moderate-intensity statins. It is not known what proportion of ASCVD patients would qualify for evolocumab based on FOURIER entry criteria and how eligibility would change if maximal doses of evidence-based lipid lowering therapies were required. We assessed the number and proportion of U.S. Veterans with ASCVD who would qualify for evolocumab based on FOURIER trial entry criteria and how these figures would change if high-intensity statins, ezetimibe or the combination of both agents was used.
- Received March 22, 2017.
- Revision received April 24, 2017.
- Accepted April 28, 2017.