Presentation (CTI)

OBJECTIVES: Inclisiran, a novel siRNA therapy, offers significant LDL-C reduction, yet its economic value in the Egyptian healthcare system remains unquantified. This study evaluated the cost-utility of adding Inclisiran to standard of care (SoC) for the secondary prevention of cardiovascular disease (CVD) in Egypt.
METHODS: A Markov cohort model with a lifetime horizon was developed from a public payer perspective. Clinical efficacy was derived from ORION trials, while costs were sourced from local Egyptian hospital tariffs. Uncertainty was explored through deterministic and probabilistic sensitivity analyses (PSA).
RESULTS: The base-case ICER was 11,623,189 EGP per QALY gained, far exceeding the Egyptian willingness-to-pay (WTP) threshold of 150,000-450,000 EGP per QALY (1-3× GDP per capita). Probabilistic sensitivity analysis demonstrated that the probability of Inclisiran being cost-effective remained 0% across the evaluated WTP range. The tornado analysis identified the drug acquisition cost as the primary driver of cost-effectiveness outcomes.
CONCLUSIONS: At its current list price, Inclisiran is not a cost-effective strategy for the Egyptian public payer. To achieve the 1x GDP threshold (150,000 EGP), a price reduction exceeding 90% (to approximately 3,000-5,000 EGP per dose) is required. Strategic value-based pricing is essential for sustainable integration into the national formulary.