Apolipoprotein B Cost-Effective for Guiding Primary Prevention Lipid-Lowering Therapy

MONDAY, April 13, 2026 (HealthDay News) -- Apolipoprotein B (apoB) can be used as a cost-effective marker to guide primary prevention lipid-lowering therapy (LLT) compared with low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C), according to a study published online April 8 in the Journal of the American Medical Association.Samuel Luebbe, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined the relative cost-effectiveness of intensifying LLT for primary prevention based on LDL-C, non-HDL-C, and apoB goals using a computer simulation model. A cohort of 250,000 statin-eligible and atherosclerotic cardiovascular disease-free U.S. adults was constructed from 4,149 participants from the 2005 to 2016 National Health and Nutrition Examination Survey. If individuals did not achieve a treated LDL-C level <100 mg/dL, non-HDL-C level <118 mg/dL, or apoB level <78.7 mg/dL, LLT was intensified.The researchers found that 965 quality-adjusted life-years (QALYs) would be gained with a non-HDL-C goal compared with an LDL-C goal, together with a $2.1 million reduction in costs. Overall, 1,324 QALYs would be gained with an apoB goal compared with a non-HDL-C goal, together with a $40.2 million increase in costs, for an incremental cost-effectiveness ratio of $30,300 per QALY gained. An apoB goal was optimal in 65 percent of probabilistic analyses and a non-HDL-C goal was optimal in 25 percent at a willingness-to-pay threshold of $120,000 per QALY gained."We found that apoB testing to intensify cholesterol-lowering medication would prevent more heart attacks and strokes than current practice, and that these health benefits were achieved at a cost that represents good value for U.S. health care payers," lead author Ciaran Kohli-Lynch, Ph.D., also from the Feinberg School of Medicine, said in a statement.One author disclosed ties to 3M; a second author disclosed ties to Boehringer Ingelheim.Abstract/Full Text (subscription or payment may be required).Sign up for our weekly HealthDay newsletter

Apolipoprotein B Cost-Effective for Guiding Primary Prevention Lipid-Lowering Therapy

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