<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2954-3835</journal-id>
<journal-title><![CDATA[Cardiovascular and metabolic science]]></journal-title>
<abbrev-journal-title><![CDATA[Cardiovasc. metab. sci]]></abbrev-journal-title>
<issn>2954-3835</issn>
<publisher>
<publisher-name><![CDATA[Asociación Nacional de Cardiólogos de México A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2954-38352022000200052</article-id>
<article-id pub-id-type="doi">10.35366/105819</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Economic evaluation of evolocumab in uncontrolled patients with high-risk cardiovascular disease affected by primary hypercholesterolemia and mixed dyslipidemia]]></article-title>
<article-title xml:lang="es"><![CDATA[Evaluación económica de evolocumab en pacientes con enfermedad cardiovascular de alto riesgo con hipercolesterolemia primaria y dislipidemia mixta no controlados]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carlos-Rivera]]></surname>
<given-names><![CDATA[Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guzmán-Caniupan]]></surname>
<given-names><![CDATA[Jorge Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Garduño]]></surname>
<given-names><![CDATA[Adolfo Gabriel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alva-Esqueda]]></surname>
<given-names><![CDATA[Mónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Camacho-Cordero]]></surname>
<given-names><![CDATA[Luis Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Maraumont]]></surname>
<given-names><![CDATA[Therese Aubry-de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,AHS Health Consulting, S.A.S. de C.V Pharmacoeconomics Department ]]></institution>
<addr-line><![CDATA[Huixquilucan State of Mexico]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,AHS Health Consulting, S.A.S. de C.V Access Department ]]></institution>
<addr-line><![CDATA[Huixquilucan State of Mexico]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,AHS Health Consulting, S.A.S. de C.V  ]]></institution>
<addr-line><![CDATA[Huixquilucan State of Mexico]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Health Economics Amgen Mexico  ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Health Economics Amgen Mexico  ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Health Economics Amgen Mexico  ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>07</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>07</month>
<year>2022</year>
</pub-date>
<volume>33</volume>
<numero>2</numero>
<fpage>52</fpage>
<lpage>63</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2954-38352022000200052&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2954-38352022000200052&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2954-38352022000200052&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Cardiovascular diseases (CVDs) are the leading cause of death worldwide, imposing an enormous clinical and financial burden on healthcare systems. An elevated level of low-density lipoprotein cholesterol (LDL-C) constitutes one of the most important modifiable risk factors for CVDs.  Objectives:  To assess the economic and health outcomes of evolocumab (EVO) added to standard of care (SoC, high-intensity statin with/without ezetimibe) in uncontrolled high-risk adult patients with primary hypercholesterolemia and mixed dyslipidemia (PHMD) in the Mexican Institute of Social Security.  Material and methods:  Using a lifetime Markov model comprising seven health states with annual cycles, we compared the direct medical costs (acquisition of lipid-lowering therapies besides the costs associated with each health state and costs for a transitory event called revascularization), and life-years (LY) expected with EVO+SoC vs SoC alone. The target population was categorized into two groups: PHMD with a history of either myocardial infarction or ischemic stroke and heterozygous familial hypercholesterolemia (HeFH). Both future costs and LY were discounted at a 5% annual rate.  Results:  EVO+SoC had a higher acquisition cost than SoC but was also more effective. The cost per LY additionally gained by using EVO was modeled as $348,629 (MXN) in the first subpopulation and $298,148 (MXN) in patients with HeFH. The model remained robust to plausible changes in the parameters. The probability of EVO+SoC being cost-effective under a willingness to pay threshold of 3 times the gross domestic product per capita estimated for 2020 in Mexico was close to 100% in both subpopulations.  Conclusions:  EVO+SoC may provide a cost-effective intervention.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  Las enfermedades cardiovasculares (ECVs) son la principal causa de mortalidad mundial, imponiendo una enorme carga clínica/financiera a los sistemas de salud. Un nivel elevado de colesterol de lipoproteínas de baja densidad (C-LDL) constituye uno de los factores de riesgo modificables más importantes para ECVs.  Objetivos:  Evaluar desenlaces económicos y de salud de evolocumab (EVO) agregado al estándar de atención (SoC, estatina de alta intensidad con/sin ezetimiba) en adultos de alto riesgo no controlados, con hipercolesterolemia primaria y dislipidemia mixta (HPDM) en el Instituto Mexicano del Seguro Social.  Material y métodos:  Usando un modelo Markov de siete estados de salud, de por vida con ciclos anuales, comparamos costos directos (adquisición de terapias hipolipemiantes, costos según estados de salud y del evento transitorio «revascularización») y años de vida (AV) esperados con EVO+SoC vs SoC. La población objetivo se dividió en dos grupos: HPDM con antecedentes de infarto de miocardio o accidente cerebrovascular isquémico; hipercolesterolemia familiar heterocigótica (HFHe). Costos y AV futuros se descontaron 5% anualmente.  Resultados:  EVO+SoC fue más costoso y más efectivo que SoC. El costo por AV ganado por el uso de EVO fue $348,629 (MXN) en la primera subpoblación y $298,148 (MXN) en pacientes con HFHe. El modelo se mantuvo robusto ante cambios plausibles en los parámetros. La probabilidad de que EVO+SoC sea costo-efectivo para un umbral de aceptabilidad igual a tres veces el producto interno bruto per cápita estimado para 2020 en México fue cercana a 100% en ambas subpoblaciones.  Conclusiones:  EVO+SoC puede proveer una intervención costo-efectiva.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Economic evaluation]]></kwd>
<kwd lng="en"><![CDATA[cost-effectiveness]]></kwd>
<kwd lng="en"><![CDATA[economic impact]]></kwd>
<kwd lng="en"><![CDATA[evolocumab]]></kwd>
<kwd lng="en"><![CDATA[cardiovascular disease]]></kwd>
<kwd lng="en"><![CDATA[hypercholesterolemia]]></kwd>
<kwd lng="es"><![CDATA[Evaluación económica]]></kwd>
<kwd lng="es"><![CDATA[costo-efectividad]]></kwd>
<kwd lng="es"><![CDATA[impacto económico]]></kwd>
<kwd lng="es"><![CDATA[evolocumab]]></kwd>
<kwd lng="es"><![CDATA[enfermedad cardiovascular]]></kwd>
<kwd lng="es"><![CDATA[hipercolesterolemia]]></kwd>
</kwd-group>
</article-meta>
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