Cost-Effectiveness of ApoB, Non–HDL-C, and LDL-C Goals for Primary Prevention Lipid-Lowering Therapy

In primary prevention, would using an apolipoprotein B (apoB) goal to guide intensification of lipid-lowering therapy (LLT) be more cost-effective than a low-density lipoprotein cholesterol (LDL-C) or non–high-density lipoprotein cholesterol (non–HDL-C) goal?In this computer simulation economic evaluation study, the cost-effectiveness of LDL-C, non–HDL-C, and apoB goals for LLT was compared in a cohort of 250 000 atherosclerotic cardiovascular disease–free and statin-eligible US adults. An apoB goal was estimated to produce the most quality-adjusted life-years and was highly cost-effective.The results of this study support the use of apoB as a cost-effective marker to guide primary prevention LLT and improve population health.

Corresponding Author: Ciaran N. Kohli-Lynch, PhD, MSc, Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, 680 N Lake Shore Dr, Ste 1400-051, Chicago, IL 60611 (ciaran.kohli-lynch@northwestern.edu).

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