A Systematic Review of Cost-Effectiveness of Non-Statin Lipid-Lowering Drugs for Primary and Secondary Prevention of Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus

Abushanab et al., 2023 | Curr Probl Cardiol | Systematic Review

Citation

Abushanab Dina, Al-Badriyeh Daoud, ... Ademi Zanfina. A Systematic Review of Cost-Effectiveness of Non-Statin Lipid-Lowering Drugs for Primary and Secondary Prevention of Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus. Curr Probl Cardiol. 2023-Aug;48(8):101211. doi:10.1016/j.cpcardiol.2022.101211

Abstract

Although studies of nonstatin lipid-lowering therapies have demonstrated cardiovascular benefits; whether these benefits provide good value has not been evaluated in type 2 diabetes mellitus patients. A systematic review was performed to include studies on the cost-effectiveness of non-statin lipid-lowering therapies in type 2 diabetes mellitus patients with/without cardiovascular disease. Thirteen studies were included; ezetimibe (n = 8), proprotein convertase subtilisin/kexin type 9 inhibitors (n = 4), fenofibrate (n = 2), nicotinic acid (n = 1), extended-release niacin/laropiprant (n = 1), and icosapent ethyl (n = 1). Six studies considered ezetimibe + statin to be a cost-effective compared to statins monotherapy, three studies suggested that proprotein convertase subtilisin/kexin type 9inhibitors + statins were not cost-effective compared to statin + ezetimibe. Fenofibrate was a cost-effective either as monotherapy or combined with a statin compared to statin or fenofibrate monotherapy. Nicotinic acid and proprotein convertase subtilisin/kexin type 9 compared to statin monotherapy were also cost-effective. Icosapent ethyl was cost-effective compared to standard care but not using the wholesale acquisition cost.

Key Findings

Icosapent ethyl was cost-effective compared to standard care but not using the wholesale acquisition cost.

Outcomes Measured

Requires manual extraction

Population

Field	Value
Population	See abstract
Sample Size	8
Age Range	See abstract
Condition	diabetes

MeSH Terms

Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Anticholesteremic Agents
Cardiovascular Diseases
Fenofibrate
Niacin
Diabetes Mellitus, Type 2
Cost-Benefit Analysis
Secondary Prevention
Ezetimibe
Proprotein Convertases
Subtilisins
Lipids

Evidence Classification

Level: Systematic Review
Publication Types: Systematic Review, Journal Article
Vertical: niacin

Provenance

PMID: 35460688
DOI: 10.1016/j.cpcardiol.2022.101211
PMCID: Not in PMC
Verified: 2026-04-09 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-09