Abstract 4138294: Medicare Utilization and Associated Spending on Icosapent Ethyl

Introduction: In 2019, Icosapent Ethyl became the first US Food and Drug Administration (FDA) approved medication for reducing cardiovascular risk beyond cholesterol-lowering therapy in high-risk patients. It was approved specifically as an adjunct to maximal tolerated statin therapy to reduce cardiovascular risk in adult patients with elevated triglyceride (TG) levels. The National Lipid Association now has a Class I recommendation for the use of icosapent ethyl (4 g/d) to reduce cardiovascular risk in patients with TG > 150 mg/dl. Methods: We analyzed available data from Medicare Part D prescription drug events published from the year 2018 to 2022. All data were de-identified and made publicly available. All costs were adjusted for inflation and represented in 2022 US dollars. Results: The number of Medicare Part D beneficiaries prescribed Icosapent Ethyl increased from 141,336 to 303,971 (215%) between 2018 and 2022 (Fig. A) and the number of claims increased from 704,334 to 1,527,133 (216%) (Fig. B). The total spending increased from $278 million to $787 million (282%) within the same timeframe (Fig. C). The average spending per claim has increased from $396 to $515 (130%) (Fig. D) and the average spending per beneficiary has also increased from $1976 to $2591 (131%) (Fig. E) between 2018 and 2022. Discussion: We observed a marked increase in the use of icosapent ethyl from 2018 to 2022. We can see a sharp rise of 187% in beneficiaries from 2018 to 2019 following FDA approval. The total number of claims and total spending also increased by 181% and 200%, respectively, from 2018 to 2019. The average spending per claim and average spending per beneficiary has increased from 2018 to 2022. It also demonstrates the cost burden to Medicare with the use of such lipid-lowering agents. Many Medicare plans include icosapent ethyl as a Tier 4 drug, which is the second most expensive drug tier. Limitations: The pattern of data used may not be generalizable to other payer demographics. Policy changes can affect the comparability of data over different periods. Conclusion: Our data highlights the increasing use of icosapent ethyl as a cardiovascular risk-reduction medication in the Medicare population. There has been a steady increase in the number of claims and beneficiaries since the approval of icosapent ethyl with an increase in average spending from 2018 to 2022.