Conclusions

In this modelled analysis, earlier addition of inclisiran to statin therapy for Aboriginal and Torres Strait Islander Australians with established CVD and hypercholesterolaemia was associated with projected reductions in cardiovascular burden, including an estimated 6401 fewer non-fatal cardiovascular events and 23,730 QALYs gained over 25 years. At an incremental cost of AUD 1.16 billion (0.32% of annual Australian government CVD expenditure), the ICER of AUD 48,808 per QALY gained was within the range of commonly referenced Australian willingness-to-pay thresholds. Cost-effectiveness improved with lower inclisiran pricing and earlier treatment initiation. These findings suggest that earlier, equity-focused access to inclisiran may represent a potentially cost-effective secondary prevention strategy and may help inform future reimbursement, guideline, and cardiovascular prevention policy decisions in Australia.