Cost-Effectiveness of Icosapent Ethyl for Ischemic Cardiovascular Events

Hamid  Pourasghari; Samad  Azari; Negar  Omidi; Jalal  Arabloo; Soheila  Rajaie; Mohammad Ali  Rezaei; Masoud  Behzadifar; Masih  Tajdini

doi:10.18502/jthc.v19is1.18478

Hamid Pourasghari Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Samad Azari Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Negar Omidi Cardiovascular Imaging Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran Heart Center, Tehran, Iran.
Jalal Arabloo Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Soheila Rajaie Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran
Mohammad Ali Rezaei Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Masoud Behzadifar Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
Masih Tajdini Postdoctoral Research Fellow, Division of Cardiology, Johns Hopkins School of Medicine.

DOI: https://doi.org/10.18502/jthc.v19is1.18478

Keywords: Cost-effectiveness; Icosapent Ethyl; Statins; Cardiovascular disease; Systematic review

Abstract

Background: Icosapent ethyl (IPE) has demonstrated efficacy and safety in reducing the risk of ischemic cardiovascular disease. This study aimed to systematically gather and synthesize existing cost-effectiveness analyses of IPE combined with statin therapy for cardiovascular risk reduction in primary and secondary prevention settings.

Methods: Comprehensive electronic searches were conducted across PubMed/MEDLINE, Scopus, Web of Science Core Collection, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the NHS Economic Evaluation Database (NHS EED), and the Health Technology Assessment (HTA) database to identify relevant literature (up to May 2024). From an initial pool of 580 studies, 11 met the predefined inclusion criteria.

Results: The findings demonstrated that IPE significantly decreased hospitalization and mortality rates compared to standard treatments. The study indicated that IPE provided greater quality-adjusted life years and life-years gained than statin therapy alone. However, IPE is more expensive than conventional medications, such as statins. For instance, the 1-year cost of IPE is $3768 in Australia and $3497 in the United States per patient. Additionally, the results revealed that the threshold for assessing the effectiveness of IPE ranged from $50,000 to $150,000 in the United States and AUD 50,000 ($39,000) in Australia.

Conclusion: Based on the current study, IPE is cost-effective, with a higher probability of cost-effectiveness in patients undergoing secondary prevention than those in primary prevention