Novel Cardiovascular Treatments Priced Too High

A cost analysis of cardiovascular medications approved between 2011 and 2016 found that prices are dramatically disproportionate to the clinical benefit, according to a presentation at the AHA 2017 Scientific Sessions. 

“As the prevalence of cardiovascular disease (CVD) continues to rise, suboptimal affordability of essential medications may become an increasingly important public health challenge,” Ohad Oren, MD, of the department of internal medicine at the Pennsylvania Hospital of the University of Pennsylvania, and colleagues wrote.

In order to determine the incremental cost-effectiveness ratio (ICER) of CVD drugs approved between 2011 and 2016, Dr Oren and colleagues analyzed the clinical trials used to approve 17 drugs.  They eliminated eight drugs that were combinations of existing drugs, reversal agents, generics, or K binders—and only focused on the remaining nine novel therapies. They determined the ICER value for each drug and compared results to the drug’s list price.

Study results showed that cost inflation ranged from 40.3% for Savaysa (Edoxaban; Daiichi Sankyo) to 3900% for Repatha (evolocumab; Amgen). 

Furthermore, they found that the mean ICER value was $89,480 per QALY—with PCSK9 inhibitors representing the higherst ICER values ($326,100 - $152,266). 

When the researchers compared ICER values to those of drugs approved in the 1990s, they found that ICER values were significant higher for the drugs approved more recently.

“The incremental cost of novel therapeutics in cardiovascular medicine is disproportionate to the enhanced clinical outcomes associated with them,” Dr Oren and colleagues concluded. “Lipid-lowering therapies top the list of high-ICER drugs, but other medications similarly demonstrate unsustainable cost growth compared with their enhanced efficacy.”

—David Costill