OBJECTIVES: Assess the cost-effectiveness of obicetrapib, a novel cholesteryl ester transfer protein (CETP) inhibitor as adjunctive therapy to maximally tolerated statins to reduce low-density lipoprotein cholesterol (LDL-c) and reduce the incidence of associated Major Adverse Cardiac Events (MACE).

METHODS: A published Markov model was adapted to simulate outcomes for a 10,000-patient cohort on maximally tolerated stable dose statin, over a lifetime horizon. The model contained three states – Above Goal, At Goal, and Death. Patients entered in “Above Goal” state, defined by LDL-c above 100 mg/dL in patients without a history of ACSVD (“Primary Prevention”). Outcomes were derived from the Phase 2 ROSE study. MACE (stroke, myocardial infarction (MI), revascularization, cardiovascular-related death) were estimated using published risk rates. Age-adjusted mortality was estimated using United States census tables. Life years gained (LYG), quality-adjusted life years (QALYs) gained, MACE and other adverse events were calculated. Direct medical costs were considered, including pharmaceutical and associated medical costs. One-way and probabilistic sensitivity analyses were conducted.

RESULTS: Adjunctive obicetrapib was cost-effective at $150,000 per QALY compared to maximally tolerated statin monotherapy in both the Primary and Secondary prevention cohorts. Over the lifetime horizon, obicetrapib polypharmacy reduced all MACE in the base case. Patients treated with obicetrapib had 800 fewer MI, 200 fewer strokes, and 700 fewer revascularizations. Overall, obicetrapib plus maximally tolerated statins resulted in 0.49 more QALYs in the Primary Prevention arm. Fewer events in the obicetrapib cohort yielded significant medical cost savings, offsetting associated polypharmacy costs.

CONCLUSIONS: Millions of patients treated with maximally tolerated statins are unable to reach and maintain LDL-c goals as defined by the AHA/ACC. A regimen of obicetrapib plus maximally tolerated statins is a cost-effective way to drive goal attainment, reduce serious cardiovascular events, and gain quality-adjusted life years.