Int J Cardiol Cardiovasc Risk Prev. 2026 Aug 7;30:200687. doi: 10.1016/j.ijcrp.2026.200687. eCollection 2026 Sep.
ABSTRACT
BACKGROUND: Aboriginal and Torres Strait Islander Australians experience substantially higher rates of cardiovascular disease (CVD), premature mortality, and related healthcare expenditure than non-Indigenous Australians. Improved management of modifiable risk factors, including hypercholesterolaemia, may reduce this excess burden. Inclisiran is a small interfering RNA therapy that provides sustained reductions in low-density lipoprotein cholesterol (LDL-C). Its cost-effectiveness as an earlier secondary prevention strategy in high-risk populations remains uncertain. We evaluated the cost-effectiveness of earlier addition of inclisiran to statin therapy for Aboriginal and Torres Strait Islander Australians with established CVD.
METHODS: A health economic analysis was undertaken from the Australian healthcare system perspective. A 25-year Markov cohort state-transition model with annual cycles was developed using the best available Australian epidemiological and cost data. Aboriginal and Torres Strait Islander Australians with established CVD and hypercholesterolaemia were modelled to receive inclisiran plus statin therapy or statin therapy alone. Model outputs included the incremental cost-effectiveness ratio (ICER), non-fatal CVD events avoided, and quality-adjusted life years (QALYs) gained. Deterministic sensitivity analyses were performed.
RESULTS: Among an estimated 12,180 eligible individuals, earlier inclisiran use was modelled to avert 6401 non-fatal CVD events and gain 23,730 QALYs over 25 years, at an additional cost of AUD 1.16 billion (AUD 46.3 million annually; 0.32% of annual Australian CVD expenditure). The ICER was AUD 48,808-per-QALY gained. Cost-effectiveness improved with lower inclisiran pricing and earlier treatment initiation.
CONCLUSIONS: In this modelled analysis, earlier addition of inclisiran to statin therapy may represent a cost-effective secondary prevention strategy for Aboriginal and Torres Strait Islander Australians with established CVD. Earlier access could reduce projected cardiovascular burden and may inform future reimbursement, guideline, and equity-focused prevention policy in Australia.
PMID:42633051 | PMC:PMC13498953 | DOI:10.1016/j.ijcrp.2026.200687