title: Estimating health and economic benefits from using prescription omega-3 fatty acids in patients with severe hypertriglyceridemia.
abstract: Patients with increased triglyceride levels compared to those with normal levels are at higher risk for coronary heart disease. In patients with severe (≥500 mg/dl) hypertriglyceridemia (SHTG), clinical trials have demonstrated that prescription ω-3 fatty acids (P-OM3s) 4 g/day can decrease triglyceride levels by 45%. However, the precise health and economic benefits of decreasing SHTG with P-OM3 are unknown. We used the previously validated Archimedes model to simulate a 20-year trial involving subjects 45 to 75 years old with SHTG. The trial consisted of an intervention arm (P-OM3 4 g/day) and a control arm. Simulation results for the control arm indicated that subjects with SHTG are at about 2 times higher risk for myocardial infarction than those with normal triglyceride levels. Using estimates from previous epidemiologic studies and meta-analyses with OM3s, the model predicted 29% to 36% decreases in various measurements of adverse cardiac events for the intervention arm. The model also predicted a decrease in ischemic stroke of 24% (95% confidence interval 15 to 33). For the 20-year simulated trial, the cost per quality-adjusted life-year gained for the currently available P-OM3 approved by the Food and Drug Administration was $47,000. Results remained robust under different clinical assumptions. In our model P-OM3 was effective in decreasing triglyceride levels and cardiovascular disease risk in patients with SHTG. In conclusion, P-OM3 medication is cost effective in our simulated trial and comparable to other cost-effective cardiovascular interventions.
authors.affiliation: Archimedes, Inc., San Francisco, California, USA. stuart.samuel@archimedesmodel.com
authors.forename: Stuart
authors.initials: S
authors.lastname: Samuel
authors.forename: Barbara
authors.initials: B
authors.lastname: Peskin
authors.forename: Bhakti
authors.initials: B
authors.lastname: Arondekar
authors.forename: Peter
authors.initials: P
authors.lastname: Alperin
authors.forename: Susan
authors.initials: S
authors.lastname: Johnson
authors.forename: Ian
authors.initials: I
authors.lastname: Blumenfeld
authors.forename: Glenda
authors.initials: G
authors.lastname: Stone
authors.forename: Terry A
authors.initials: TA
authors.lastname: Jacobson
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000188:drug therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009203:Myocardial Infarction / Q000517:prevention & control; D019057:Quality-Adjusted Life Years; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015525:Fatty Acids, Omega-3