725 Cost Effectiveness of Bempedoic Acid for Those at High Risk Cardiovascular Disease

Abstract

Bempedoic acid is a novel adenosine triphosphate (ATP) citrate lyase inhibitor. The Cholesterol Lowering via Bempedoic Acid, an ACL-Inhibiting Regimen (CLEAR) Harmony trial demonstrated that bempedoic acid, in addition to statin therapy, significantly reduced low-density lipoprotein cholesterol (LDL-C) in patients at high risk of cardiovascular disease (CVD). The price at which bempedoic acid would be considered cost-effective to the Australian healthcare system is currently unknown. A Markov model was designed comprising 1000 patients profiled on the CLEAR Harmony cohort, to model their clinical outcomes and costs over a 25-year time horizon. The health states were: ‘Alive with CVD’, ‘Alive with Recurrent CVD’ and ‘Dead’. Patients were at risk of coronary revascularisation, non-fatal myocardial infarction and death from CVD or non-CVD causes in each annual cycle. Costs and utility data were estimated from published sources. Outcomes of interest were the incremental cost-effectiveness ratios (ICERs) based on cost per quality-adjusted life year (QALY) and cost per year of life saved (YoLS). All outcomes were discounted at 5% per year. At AU$584.40 per annum, bempedoic acid in addition to statin therapy, was estimated to save 0.122 (discounted) years of life and 0.103 (discounted) QALYs per person at a net cost of AU$5,159 per person. Overall, this resulted in ICERs of AU$49,980 per QALY gained and $42,433 per YoLS. Bempedoic acid is a promising adjunct therapy for the management of high CVD risk patients and would be considered cost-effective if its annual acquisition cost does not exceed AU$600 per person.