Excellent analysis of the REDUCE-IT study by @matthewherper, but there's one issue that I would like to point out as well https://www.forbes.com/sites/matthewherper/2018/11/10/fish-oil-derived-drug-shows-great-promise--with-big-caveats/#35596a333291 …
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As per the study, the absolute risk difference between the active and placebo groups was ~5% The calculated NNT - which was in the study (hurray!) - was 21 This means 21 people needed to take Vascepa for 5 years to prevent 1 endpointpic.twitter.com/bilSF7ePOY
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This is great because it allows us to calculate the cost-benefit of Vascepa for these endpoints Vascepa = ~$250 USD per month This equates to a 5-year cost of $15,000
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Now we multiply that by the NNT = 21 21 patients * $15,000 = $315,000 cost to prevent one study endpoint
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Now this may be cost-effective - the composite "cardiovascular endpoint" score was derived from, among other things, death and heart attacks But it's worth noting that the medication is VERY expensive which offsets its usefulness a lot
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Replying to @matthewherper
True, but the participants were already taking statins from my understanding? So the ICER would be compared to other cardiac medications, which may prevent more events or have a similar NNT but for a shorter time-period, all on top of statins
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Replying to @GidMK @matthewherper
Sorry, when I say VERY expensive what I mean is the price per prevented event is high, not that the absolute cost is high
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Willingness-to-pay is usually set at GDP, so a cost of $315,000 would be about 3x the WTP threshold in the US. If it's preventing deaths, that might come out cost-effective, but my guess is you'd have to halve the cost of the medication to see a positive CEA
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