RNA therapeutics
Early health-economic modelling of olpasiran and pelacarsen offers a preview of Lp(a)-lowering RNA therapies' value ahead of outcomes-trial results, review argues (Curr Opin Endocrinol Diabetes Obes 2025)
Original title: Perspectives on early health economic evaluations of RNA therapies targeted at lipoprotein(a)
This review by Burvill, Watts and Ademi examines the role of early health economic evaluation for RNA-based Lp(a)-lowering therapies, which if approved would likely first be used in adults with established atherosclerotic cardiovascular disease (ASCVD) and very high Lp(a), a population with high absolute recurrent-event risk in whom elevated Lp(a) serves as a risk-enhancing factor. The authors note that potent Lp(a) lowering in secondary prevention may produce meaningful relative risk reductions in coronary heart disease or ASCVD events, though this needs confirmation from ongoing and future clinical trials, and they review one existing early economic evaluation estimating the value of olpasiran and pelacarsen against standard-of-care secondary prevention across different willingness-to-pay thresholds. They conclude that early economic evaluations, built on the best currently available causal evidence linking Lp(a) to cardiovascular disease, can usefully estimate longer-term clinical benefit and cost implications while awaiting results from major cardiovascular outcomes trials.
Original abstract
Purpose Of Review: Early health economic evaluations of new medications are useful, as they consider the implications for health services.We reviewed recent literature on expected clinical outcomes of lowering of elevated plasma lipoprotein(a) [Lp(a)] in secondary prevention, which is essential information on effectiveness for economic evaluations.We reviewed a recent early economic evaluation of RNA therapies targeted at Lp(a).
Recent Findings: RNA-based therapies, if approved, would likely be used initially in adults with established atherosclerotic cardiovascular disease (ASCVD) and very high Lp(a). Adults with ASCVD have high absolute risk of recurrent events and elevated Lp(a) serves as a risk-enhancing factor.Potent lowering of Lp(a) in secondary prevention may be associated with significant relative risk reductions of coronary heart disease or ASCVD events; this needs confirmation in currently ongoing and future clinical trials.One economic evaluation has estimated the value of olpasiran and pelacarsen, at various willingness-to-pay thresholds, compared with standard-of-care secondary prevention.
Summary: Early economic evaluations estimate longer-term clinical benefits and cost consequences associated with new medications.Existing casual evidence of Lp(a) and cardiovascular disease can be used in early economic evaluations as best available evidence, while awaiting results from major cardiovascular outcomes trials.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.