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ACC.20 World Congress of Cardiology Virtual

Selected abstracts are available online now:

https://www.abstractsonline.com/pp8/#!/8992/presentation/23391
1161-128 / 128 - COST-EFFECTIVENESS OF ICOSAPENT ETHYL IN US REDUCE-IT PATIENTS
March 28, 2020, 12:30 PM - 1:15 PM eAbstract Virtual Hall
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Authors
William S. Weintraub, Deepak Bhatt, Zugui Zhang, Cheng Zhang, Dolman Sarahfaye, William E. Boden, Philippe Gabriel Steg, Michael Miller, Eliot Brinton, Jordan King, Adam Bress, Terry Jacobson, Jean Claude Tardif, Christie M. Ballantyne, Paul Kolm, MedStar Washington Hospital Center, Washington, DC, USA
Abstract
Background: The Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) showed that among US patients with elevated triglyceride levels on statin therapy (n=3,146), the risk of cardiovascular disease events was reduced by 31% in those randomized to 4g of icosapent ethyl daily compared to placebo. We determined cost-effectiveness of icosapent ethyl compared to standard care in US patients.
Methods: This was a patient level cost-effectiveness analysis of US subjects using data from REDUCE-IT. Costs were based on Optum costs for those under age 65 years and Medicare for those at or over age 65. Icosapent ethyl cost was $4.16 a day, based on SSR net cost. Utility was from the literature. Quality adjusted life years (QALYS) were calculated as survival x utility. The primary outcome measure was the incremental cost-effectiveness ratio (ICER), defined as cost per QALY gained. Where icosapent ethyl was dominant (i.e., better outcome at lower cost), the ICER was not calculated. The percent dominant was calculated at thresholds of $50,000, $100,000, and $150,000 per QALY gained. The time horizon was in-trial, the perspective was payer. The subgroups of primary vs secondary prevention were assessed.
Results: Overall, icosapent ethyl was a dominant strategy in 85.2% of simulations, and the probability of being cost-effective was, at the $50,000, $100,000, and $150,000 thresholds, shown in 99.7%, 99.7%, and 99.9% of simulations, respectively. In primary prevention, the ICER was $36,118/QALY gained, and the probability of icosapent ethyl being cost-effective was, at the $50,000, $100,000, and $150,000 thresholds, shown in 62.3%, 79.1%, and 83.5% of simulations, respectively. In secondary prevention, icosapent ethyl was dominant in 98.6% of simulations, and the probability of being cost-effective was, at the $50,000, $100,00, and $150,000 thresholds, shown in 100% of simulations.
Conclusion: In the United States, icosapent ethyl was shown to be dominant overall, cost-effective in primary prevention, and dominant in secondary prevention.