Budget Impact Analysis of Inclisiran for the Management of Patients With Atherosclerotic Cardiovascular Disease in India: A Multipayer Analysis
Author(s)
Dimple Butani, MPH1, Vidya Chellasamy, MPH2, Pallavi Kawatra, MD, MBBS1, Palvi Kudyar, DM, MD, MBBS1, Chanakya Misra, PGPM, B. Pharm1, Rishi Jain, MD, MBBS1, Prateek Tandon, PGPM, MSc, and BSc1.
1Novartis Healthcare Pvt. Ltd, Mumbai, Maharashtra, India, 2Novartis Healthcare Pvt. Ltd, Hyderabad, Telangana, India.
1Novartis Healthcare Pvt. Ltd, Mumbai, Maharashtra, India, 2Novartis Healthcare Pvt. Ltd, Hyderabad, Telangana, India.
OBJECTIVES: To evaluate budget impact of introducing Inclisiran for adults with atherosclerotic cardiovascular disease (ASCVD) in India on maximally tolerated statins and need further low-density lipoprotein cholesterol (LDL-C) reduction.
METHODS: A budget impact analysis (BIA) from public and private payer perspectives over prospectively over a period of 5- years. The analysis compared scenerios: a) with and b) without Inclisiran + standard of care (SoC) against existing market :SoC alone (includes high dose statins); evolocumab+SoC; bempedoic acid+SoC; ezetimibe+SoC and bempedoic acid+SoC+ezetimibe. LDL-C level ≥2.5 mmol/L (100 mg/dl) used in base case and ≥3.36 mmol/L (130 mg/dl) in scenario analysis. Epidemiological data for age concerning general population, along with other relevant data for the ASCVD population, were gathered from locally published literature. Drug cost and cardiovascular events cost derived from local published literature, clinical experts and private insurance data. Efficacy data were obtained from published network meta-analysis. The market share data was derived from IQVIA sales data. Inclisiran market share was assumed to increase annually by 3.16% (uptake from SoC patients). Sensitivity analysis was performed to assess parameter uncertainty.
RESULTS: The total budget spent per person when Inclisiran is introduced to market over the course of 5 years will be €60.17 (€1= 101.35 INR) in public setup and €70.67 for private setup. The total budget saved from preventing any Major Adverse Cardiovascular Events+ (MACE+)* amounted to € 5.32 million for ASCVD population with LDL-C ≥2.5 mmol/L and €12.7 billion with LDL-C ≥3.36 mmol/L. Over five years, 28,540 MACE+ were avoided. One-way sensitivity analysis revealed budget impact is primarily affected by adjustment for age of non-fatal and fatal events, ASCVD prevalence and the event rate adjustment for CV death.
CONCLUSIONS: The BIA indicates that transitioning to Inclisiran has improved outcomes by reducing MACE+ events and associated costs, thereby alleviating the financial burden for payers.
METHODS: A budget impact analysis (BIA) from public and private payer perspectives over prospectively over a period of 5- years. The analysis compared scenerios: a) with and b) without Inclisiran + standard of care (SoC) against existing market :SoC alone (includes high dose statins); evolocumab+SoC; bempedoic acid+SoC; ezetimibe+SoC and bempedoic acid+SoC+ezetimibe. LDL-C level ≥2.5 mmol/L (100 mg/dl) used in base case and ≥3.36 mmol/L (130 mg/dl) in scenario analysis. Epidemiological data for age concerning general population, along with other relevant data for the ASCVD population, were gathered from locally published literature. Drug cost and cardiovascular events cost derived from local published literature, clinical experts and private insurance data. Efficacy data were obtained from published network meta-analysis. The market share data was derived from IQVIA sales data. Inclisiran market share was assumed to increase annually by 3.16% (uptake from SoC patients). Sensitivity analysis was performed to assess parameter uncertainty.
RESULTS: The total budget spent per person when Inclisiran is introduced to market over the course of 5 years will be €60.17 (€1= 101.35 INR) in public setup and €70.67 for private setup. The total budget saved from preventing any Major Adverse Cardiovascular Events+ (MACE+)* amounted to € 5.32 million for ASCVD population with LDL-C ≥2.5 mmol/L and €12.7 billion with LDL-C ≥3.36 mmol/L. Over five years, 28,540 MACE+ were avoided. One-way sensitivity analysis revealed budget impact is primarily affected by adjustment for age of non-fatal and fatal events, ASCVD prevalence and the event rate adjustment for CV death.
CONCLUSIONS: The BIA indicates that transitioning to Inclisiran has improved outcomes by reducing MACE+ events and associated costs, thereby alleviating the financial burden for payers.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE88
Topic
Economic Evaluation, Health Policy & Regulatory
Topic Subcategory
Budget Impact Analysis
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)