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MP463 - Icosapent Ethyl Therapy for Patients With an Established Cardiovascular Disease Provides Significantly More Value for Money Than When Prescribed as Primary Prevention

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Author Block: Ronen Arbel, Enis Aboalhasan, Sapir Coll, Sderot, Israel; Ariel Hammerman, Clalit Health Services, Tel Aviv, Israel; Joseph Azuri, Sackler Faculty of Med, Tel Aviv, Israel
Disclosure Block: R.Arbel: None. E.Aboalhasan: None. A.Hammerman: None. J.Azuri: Honoraria; Modest; Pfizer, Novonordisk, Other Research Support; Modest; Janssen Pharmaceutica.
Introduction: Icosapent ethyl is currently the only drug approved for the prevention of major adverse cardiovascular events (MACE) in patients with hypertriglyceridemia, who are already on statin therapy. The approved use is both for secondary prevention in patients with established cardiovascular disease (CVD) or primary prevention for patients with diabetes and multiple risk factors. Despite its’ proven clinical benefits, the addition of icosapent ethyl to patient’s current treatment regimens may impose a significant cost burden on healthcare systems. Hypothesis: Prioritizing icosapent ethyl therapy for patients with an established CVD may provide significantly more value for money than when prescribed as primary prevention. Methods: We performed an analysis of the cost required for icosapent ethyl per achieved outcome when prescribed either for primary or for secondary prevention of MACE. The cost needed to treat (CNT) to prevent one MACE in the REDUCE-IT trial was estimated by multiplying the annualized number needed to treat to prevent one event, by the annual cost of therapy. The market price of icosapent ethyl in the US was estimated as 75% of the US national average drug acquisition cost listing. Results: In the REDUCE-IT population, the figured CNT of Icosapent ethyl provided as primary prevention was $874,500 (95% CI: $349,800-∞) vs. $206,965 (95% CI: $160,325-$294,415) for secondary prevention; P<0.001. Conclusions: The CNT for patients receiving the drug for primary prevention of MACE was four-fold higher than when provided as secondary prevention. Our findings suggest that icosapent ethyl therapy for patients with an established CVD provides significantly more value for money.