OBJECTIVES: Elevated triglyceride levels in statin-treated patients, even with controlled low-density lipoprotein cholesterol levels, are linked with increased risk of future cardiovascular (CV) events and death. Icosapent ethyl reduces the incidence of CV events in statin-treated adult patients with established CV disease (CVD) and elevated triglycerides (≥1.7 mmol/L). This analysis aims to assess the cost-effectiveness of icosapent ethyl in patients with established CVD and recent acute coronary syndrome (ACS, defined as occurring within 12 months prior to receiving icosapent ethyl or placebo) from a Catalonian healthcare perspective.

METHODS: An established partitioned survival model with health states based on the number of CV events was developed to capture the long-term risk of major CV events. Daily cycles were used to capture all CV events from the REDUCE-IT trial. Icosapent ethyl + statins ± ezetimibe was compared to best supportive care (BSC; statins ± ezetimibe only). Efficacy/safety inputs were based on the recent ACS population of the REDUCE-IT trial. Costs and utilities were sourced from published literature, and databases, and validated by a Spanish clinical expert. Costs (reported in 2023 EUR) and quality-adjusted life years (QALYs) were discounted by 3.0% annually. Uncertainty was explored through deterministic one-way and probabilistic sensitivity analyses.

RESULTS: Icosapent ethyl was associated with €10,414 incremental costs and 0.715 incremental QALYs versus BSC. Total icosapent ethyl cost was €66,849, compared to €56,435 with BSC, whereas QALYs were 9.714 and 8.999 respectively. The cost-effectiveness acceptability curve showed a 73% probability that icosapent ethyl is cost-effective at a willingness-to-pay threshold of €30,000. The probabilistic sensitivity analysis trends were consistent with the base-case results.

CONCLUSIONS: Icosapent ethyl is a cost-effective and clinically effective intervention for statin-treated adult patients with established CVD, elevated triglycerides and recent ACS from a Catalonian healthcare perspective.