Treatments of Interest:

  • icosapent ethyl (Vascepa®, Amarin Pharma)
  • rivaroxaban (Xarelto®, Janssen Pharmaceuticals)

Cardiovascular disease (CVD) is a set of conditions that result primarily from the build-up of plaque in the blood vessels. Depending on where there is build-up, patients can have chest pain (“angina”), muscle pain with walking (“claudication”) and an increased risk of heart attack, stroke, and death. In total, CVD is estimated to affect one-half of adults in the US and is the leading cause of death across all races and ethnicities, with approximately 850,000
deaths annually.

The independent appraisal committee voted that rivaroxaban and icosapent ethyl improve patient health at prices that achieve good long-term value for money, but the large potential short-term budget impact associated with treating even a small percentage of eligible US patients lead ICER to issue an Access and Affordability Alert.

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Final Documents

Below you will find the final documents from the assessment review process:

“While aspirin and statins have become cornerstone therapies for treating cardiovascular disease, treatments like rivaroxaban and icosapent ethyl appear to provide additional benefits for certain patients who have an elevated risk of major cardiovascular events. Input from clinical experts confirmed that the ideal target population for treatment is very large, and therefore, despite being priced in a cost-effective manner, these additive treatments could pose a short-term budgetary challenge for the health system depending on how real-world uptake evolves. In these situations, it is critical for all stakeholders to work together to ensure that pricing and coverage arrangements don’t create barriers to these beneficial therapies, while balancing the need to deliver quality health care for all patients.”