Dr. Gregg Fonarow is a professor of cardiology at the University of California, Los Angeles.He also serves as director of the Ahmanson–UCLA Cardiomyopathy Center and co-chief of cardiology.He has conducted research for GlaxoSmithKline and Pfizer and serves a consultant and has received honorarium from Abbott, AstraZeneca, GlaxoSmithKline, Merck, Pfizer and Schering Plough companies.
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the University of California, Los Angeles
In order to achieve an ICER of $150,000, which is the upper limit of what is considered cost-effective therapy, the price of evolocumab would have to be reduced by approximately one-third. In these patients, evolocumab would need to be priced at $6,780 per year to be cost-effective. For them, the price of PCSK9 inhibitors would need to be reduced by 71% to be cost-effective . In their editorial, Mark, Richman, and Hlatky point out that real-world use of evolocumab might be less favorable than the modelling used by Fonarow and colleagues. Specifically, they note that the magnitude of a mortality reduction “has a profound effect on the estimated cost-effectiveness.” If no late survival benefit occurs, the ICER skyrockets to $483,800 per QALY gained and the drug would need to be priced at $7,246 to be cost-effective.
A program designed to reduce hospital readmissions reduced the rate of readmissions, but was found to increase the rate of death among hospitalized heart failure patients, reveals a new study. The Affordable Care Act of 2010 established the Hospital Readmissions Reduction Program , which involved public reporting of hospitals' 30-day readmission rates for heart failure, heart attack, and pneumonia and created financial penalties for hospitals with higher readmissions. ‘Scientists suggest to carefully reconsider the use of Hospital Readmissions Reduction Program for patients with heart failure.’ However, incentives to reduce readmissions can potentially encourage inappropriate care strategies and may adversely affect patient outcomes. The author Gregg C. Fonarow, M.D., of the Ronald Reagan-UCLA Medical Center, Los Angeles, and Associate Editor of the Health Care Quality and Guidelines section, JAMA Cardiology, and coauthors. This is an analysis of heart failure hospitalizations from hospitals participating voluntarily in a heart failure clinical registry and may not be generalizable to other hospitals.