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Updated: Jun 25, 2026
05:10
Drug Repurposing Hypothesis Generation Using the "RE:fine Drugs" System
Published on: December 11, 2016
Repurposed Drugs and Cardiovascular Morbidity: A Cost-Effectiveness Analysis
Oana-Monica Leah1, Florin G Leaşu, Mihaela Badea
1Basic, Preventive and Clinical Sciences Department, Transilvania University, Braşov, Romania.
American Journal of Therapeutics
|June 24, 2026
Summary
Generic repurposed cardiovascular drugs like ramipril and statins offer the best value for preventing heart disease. Newer agents like SGLT2 inhibitors and GLP-1 agonists provide benefits for specific patient groups.
Area of Science:
- Cardiovascular Medicine
- Pharmacoeconomics
- Drug Repurposing
Background:
- Cardiovascular disease (CVD) is the leading global cause of mortality, highlighting the need for effective prevention strategies.
- Drug repurposing offers a promising avenue for cardiovascular prevention, leveraging existing drugs with established safety profiles.
- This strategy accelerates development timelines and facilitates faster clinical implementation compared to novel drug discovery.
Purpose of the Study:
- To identify repurposed cardiovascular agents with the most favorable pharmacoeconomic profiles.
- To establish an optimal hierarchy for cardiovascular prevention based on clinical benefit, risk stratification, and economic sustainability.
Main Methods:
- A narrative review synthesizing evidence from 19 pivotal cardiovascular outcomes trials and major guidelines.
- Efficacy of 13 agents across 8 therapeutic classes was quantified using risk reductions and Number Needed to Treat (NNT).
- Pharmacoeconomic value was assessed using Incremental Cost-Effectiveness Ratio (ICER) per Quality-Adjusted Life Year (QALY).
Main Results:
- Three ICER tiers were identified: Low-cost (<$20,000/QALY) including generic agents (ramipril, carvedilol, metformin, statins) with robust mortality benefits.
- Moderate-cost ($3,000-$50,000/QALY) agents included SGLT2 inhibitors (empagliflozin, dapagliflozin), GLP-1 receptor agonists (liraglutide, semaglutide), and colchicine.
- High-cost ($80,000-$300,000/QALY) agents like PCSK9 inhibitors demonstrated proven benefits but faced pricing challenges.
Conclusions:
- Generic repurposed cardiovascular agents (ramipril, carvedilol, metformin, statins) offer the most favorable cost-effectiveness and should be foundational.
- SGLT2 inhibitors and GLP-1 receptor agonists provide significant benefits in secondary prevention for select populations.
- PCSK9 inhibitors are cost-effective only for very high-risk patients with refractory LDL cholesterol control.
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