Cost-Effectiveness of Long-Chain Omega-3 Supplementation for the Secondary Prevention of Cardiovascular Disease in the United States

Objectives A variety of eicosapentaenoic (EPA) and docosahexaenoic (DHA) omega-3 dietary supplements of varying dosage and pricing are available in the United States and commonly used for secondary cardiovascular prevention. Although these interventions’ efficacy has been studied, their cost-effectiveness remains unknown. The goal of this article is to assess whether omega-3 dietary supplements are cost-effective for secondary cardiovascular prevention in adults in the United States. Our analysis explicitly incorporates a reported higher risk of atrial fibrillation associated with omega-3 supplementation. Methods This economic evaluation used a Markov model over a 10-year horizon with health states defined by cardiovascular disease status. Effectiveness was measured by quality-adjusted life-years (QALYs) gained, and costs were calculated from a US healthcare system perspective, estimated in 2023 US dollars. Data were obtained from the published literature. Deterministic and probabilistic sensitivity analyses were conducted to estimate the influence of parameter uncertainties on the resulting cost-effectiveness ratios. Scenarios including low (300 mg/day), medium (1000 mg/day), and high (2500 mg/day) supplementation dosages of EPA and DHA omega-3s were considered. Average and incremental cost-effectiveness ratios (ICERs) in US$/QALY are presented. Results At a willingness-to-pay threshold of $50 000/QALY, 1000 mg/day is the most cost-effective dose (ICER of $ 25 024). At a willingness-to-pay of $100 000, 2500 mg/day (ICER of $57 981) is the most cost-effective dose. Conclusions These findings reveal that use of EPA and DHA omega-3 dietary supplements, in a wide range of dosages and prices, are cost-effective for secondary prevention of cardiovascular disease for US adults.