Abstract Body (Do not enter title and authors here): 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.