Abstract
AIMS: Recent trials have shown that low-dose colchicine (0.5 mg once daily) reduces major cardiovascular events in patients with acute and chronic coronary syndromes. We aimed to estimate the cost-effectiveness of low-dose colchicine therapy in patients with chronic coronary disease when added to standard background therapy.
METHODS AND RESULTS: This Markov cohort cost-effectiveness model used estimates of therapy effectiveness, transition probabilities, costs and quality of life obtained from the Low-dose Colchicine 2 (LoDoCo2) trial, as well as meta-analyses and public sources. In this trial, Low-dose colchicine was added to standard of care and compared to placebo. The main outcomes were cardiovascular events including myocardial infarction, stroke and coronary revascularisation, quality-adjusted life-year (QALY), the cost per QALY gained (incremental cost-effectiveness ratio), and net monetary benefit. In the model, low-dose colchicine therapy yielded 0.04 additional QALYs compared with standard of care at an incremental cost of €455 from a societal perspective and €729 from a healthcare perspective, resulting in a cost per QALY gained of €12,176/QALY from a societal perspective and €19,499/QALY from a healthcare perspective. Net monetary benefit was €1,414 from a societal perspective and €1,140 from a healthcare perspective. Low-dose colchicine has a 96% and 94% chance of being cost effective, from respectively a societal and healthcare perspective when using a willingness to pay of €50,000/QALY. Net monetary benefit would decrease below zero when annual low-dose colchicine costs would exceed an annual cost of €221 per patient.
CONCLUSION: Adding low-dose colchicine to standard of care in patients with chronic coronary disease is cost-effective according to commonly accepted thresholds in Europe and Australia and compares favourably in cost-effectiveness to other drugs used in chronic coronary disease.
| Original language | English |
|---|---|
| Pages (from-to) | 89-96 |
| Number of pages | 8 |
| Journal | European Heart Journal : Quality of Care & Clinical Outcomes |
| Volume | 11 |
| Issue number | 1 |
| Early online date | 14 Mar 2024 |
| DOIs | |
| Publication status | Published - Jan 2025 |
Bibliographical note
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.Funding
The Netherlands Organisation for Health Research and Development [grant number 848015014]; The Dutch Heart Foundation and The Withering Stichting in The Netherlands; National Health and Medical Research Council [grant number GTN1088455] in Australia. The authors thank all patients for their participation in the trial, as well as the trial investigators and coordinators at all centres. The drug was supplied free of charge by Tiofarma in The Netherlands and Aspen in Australia. The funders and drug suppliers had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The main trial was registered in the Australian Clinical Trials Registry (ACTRN12614000093684). The Netherlands Organisation for Health Research and Development [grant number 848015014]; The Dutch Heart Foundation and The Withering Stichting in The Netherlands; National Health and Medical Research Council [grant number GTN1088455] in Australia.
| Funders | Funder number |
|---|---|
| Hartstichting | |
| ZonMw | 848015014 |
| National Health and Medical Research Council | GTN1088455 |
| Tiofarma in The Netherlands and Aspen in Australia | ACTRN12614000093684 |
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