COST-EFFECTIVENESS OF BEMPEDOIC ACID AS ADJUNCT TO STANDARD OF CARE (SOC) THERAPY IN AUSTRALIA FOR THE TREATMENT OF ADULTS WITH HYPERCHOLESTEROLAEMIA CLASSIFIED AS EITHER HIGH-RISK PRIMARY OR SECONDARY PREVENTION
Author(s)
Scott Brydon, MBA1, Stuart Harsley, BPharm1, Joshua O' Malley, BSc (Biology); MBiotech2, Harpreet Singh, MPH2, Dominic Tilden, BCom; MPH2.
1CSL Seqirus, Melbourne, Australia, 2THEMA Consulting Pty Ltd, Sydney, Australia.
1CSL Seqirus, Melbourne, Australia, 2THEMA Consulting Pty Ltd, Sydney, Australia.
OBJECTIVES: To assess the comparative costs and outcomes of bempedoic acid plus standard of care (SOC) versus SOC alone for the treatment of hypercholesterolaemia in adults with established symptomatic atherosclerotic cardiovascular disease (ASCVD) or at high-risk of a first cardiovascular (CV) event using evidence from the pivotal CLEAR OUTCOMES Trial.
METHODS: A Markov model was developed to estimate the incremental cost per quality-adjusted life-year (QALY) gained for bempedoic acid as adjunct to SOC compared with SOC alone. The analysis adopted an Australian healthcare system perspective over 25 years in 6-monthly cycles. The model incorporated cardiovascular (CV) events and health states based on the composite endpoint of CLEAR OUTCOMES including, myocardial infarction (MI), stroke, coronary revascularisation (CR) and CV death. Transition probabilities for CV events over the initial 3.5 years were derived from the intention-to-treat population. Beyond this, CV event risks were adjusted for age and, MI and stroke case fatality rates were applied based on positively-adjudicated CV deaths. Non-CV death was informed by Australian lifetables. Utilities and event disutilities were sourced from published models. Acute CV event and long-term health state costs derived from Australian sources and previous PBAC submissions. Costs and outcomes were discounted at 5% per annum.
RESULTS: Treatment with bempedoic acid plus SOC was estimated to be associated with an additional 0.072 life years (LY) and 0.105 QALYs gained compared with SOC alone. For every 100 patients treated with bempedoic acid, the model estimated 3.9 fewer CRs, 5 fewer non-fatal MI’s, 1.2 fewer non-fatal strokes, 1.4 fewer CV deaths and 4 fewer hospitalisations for unstable angina. The incremental cost per QALY gained for bempedoic acid plus SOC compared with SOC alone was between $15,000 and $25,000.
CONCLUSIONS: Bempedoic acid is an effective and cost-effective intervention relative to current practice in Australia in patients with hypercholesterolaemia despite SOC therapy.
METHODS: A Markov model was developed to estimate the incremental cost per quality-adjusted life-year (QALY) gained for bempedoic acid as adjunct to SOC compared with SOC alone. The analysis adopted an Australian healthcare system perspective over 25 years in 6-monthly cycles. The model incorporated cardiovascular (CV) events and health states based on the composite endpoint of CLEAR OUTCOMES including, myocardial infarction (MI), stroke, coronary revascularisation (CR) and CV death. Transition probabilities for CV events over the initial 3.5 years were derived from the intention-to-treat population. Beyond this, CV event risks were adjusted for age and, MI and stroke case fatality rates were applied based on positively-adjudicated CV deaths. Non-CV death was informed by Australian lifetables. Utilities and event disutilities were sourced from published models. Acute CV event and long-term health state costs derived from Australian sources and previous PBAC submissions. Costs and outcomes were discounted at 5% per annum.
RESULTS: Treatment with bempedoic acid plus SOC was estimated to be associated with an additional 0.072 life years (LY) and 0.105 QALYs gained compared with SOC alone. For every 100 patients treated with bempedoic acid, the model estimated 3.9 fewer CRs, 5 fewer non-fatal MI’s, 1.2 fewer non-fatal strokes, 1.4 fewer CV deaths and 4 fewer hospitalisations for unstable angina. The incremental cost per QALY gained for bempedoic acid plus SOC compared with SOC alone was between $15,000 and $25,000.
CONCLUSIONS: Bempedoic acid is an effective and cost-effective intervention relative to current practice in Australia in patients with hypercholesterolaemia despite SOC therapy.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE160
Topic
Clinical Outcomes, Economic Evaluation, Health Technology Assessment
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas