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Wednesday, May 18, 2022 10:59:21 PM
American Journal of Preventive Cardiology
Volume 10, June 2022, 100345
The potential population health impact of treating REDUCE-IT eligible US adults with Icosapent Ethyl
https://www.sciencedirect.com/science/article/pii/S2666667722000290
Highlights
• An estimated 3.6 million US adults are REDUCE-IT eligible.
• An estimated 212,000 ASCVD events over five years can be prevented with icosapent ethyl therapy.
• The estimated annual cost of treating all eligible US adults with icosapent ethyl is $5.5 billion.
• An estimated $1.8 billion could be saved annually from ASCVD events prevented.
“To treat all 3.6 million REDUCE-IT eligible US adults with IPE for one year is projected to cost $6.0 billion (UR $4.7-$7.5 billion; Table 3). Using a WAC estimate of $11.48/day, the annual IPE treatment cost would be $15.1 billion (UR $11.7-18.9 billion). Discounting the SSR Health cost by 20% to account for nonadherence to a daily cost of $3.67/day would result in a projected annual treatment cost of $4.8 billion (UR $3.8-6.0 billion). Assuming a weighted mean cost of $32,980 (95% CI $20,619-$45,341) per event and, by preventing 50,000 first ASCVD events with one year of IPE treatment, $1.8 billion in event costs annually could be prevented (UR $1.3-$2.2 billion; Table 4). With one year of IPE treatment, 97,000 total (first and recurrent) events could be prevented, averting $3.4 billion in event costs annually (UR $2.5-$4.2 billion).”
“In this analysis, we did not estimate direct costs for rehabilitation or skilled nursing stays, or the impact of IPE on outpatient medical costs or indirect costs. Indirect costs, which quantify in dollars the money lost to society by an illness, are difficult to estimate. Examples include lost wages due to loss of productivity, transportation to and from medical care, and changes in lifestyle choices after an illness (e.g., diet), family and professional caregiving, among others. The indirect cost inputs used in the current study ($6,318/person) include loss of wages from not working and home productivity loss from morbidity and premature mortality. The total indirect costs estimated in this study for the entire REDUCE-IT eligible population were $22.7 billion annually. Comparatively, the annual net burden of $4.3 billion to prevent first events (and net cost of $2.6 billion to prevent total events) for IPE treatment of all eligible individuals is relatively small. If even 5% of outpatient and indirect costs are prevented with one year of treatment, then IPE is a cost-saving therapy.”
“In conclusion, the current analysis shows that if our estimated 3.6 million REDUCE-IT eligible US adults were treated for five years with IPE, 212,000 first events and 490,000 total ASCVD events could be prevented. We estimate that one year of IPE treatment for all eligible US adults would cost the health care system $6.0 billion but save $1.8 billion due to first ASCVD events prevented, for a net cost of $4.2 billion. Annually, $3.4 billion from preventing 97,000 total events (first and recurrent) could be saved, resulting in a net burden of $2.6 billion for one year of IPE therapy. Outpatient and indirect costs likely outweigh much of the net cost of IPE therapy.”
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