Heart Disease Crisis: Proven Drugs Underused as Millions Remain at Risk

DUBLIN and BRIDGEWATER, N.J. – February 23, 2026 – As the United States marks another American Heart Month, a stark reality looms over the nation's public health landscape: despite a formidable arsenal of proven, widely available medications, cardiovascular disease (CVD) continues its reign as the leading cause of death. Pharmaceutical company Amarin Corporation has issued an urgent call to action, highlighting a critical disconnect between scientific evidence and clinical practice that leaves millions of high-risk patients vulnerable to preventable heart attacks, strokes, and death.

The scale of the crisis is staggering. According to the latest statistics from the American Heart Association, a breathtaking 130.6 million U.S. adults—nearly half the adult population—were living with some form of CVD in 2023. This is not a problem of a lack of solutions, but a failure of implementation. Guideline-supported therapies with robust data proving they reduce cardiovascular events are readily available, yet a significant portion of the patient population remains untreated or undertreated.

“We do not need to wait for tomorrow’s breakthroughs to save lives today,” stated Aaron Berg, President & CEO of Amarin, in a press release. “With nearly half the nation affected by CVD, the need to deploy FDA- and EMA‑approved, foundational therapies with a history of reducing cardiovascular events such as heart attacks and strokes has never been greater. A real dent in cardiovascular disease can be made today – simply by using the tools we already have.”

The Persistent Gap Between Evidence and Practice

Modern medicine offers a powerful toolkit for managing cardiovascular risk. Foundational therapies like statins, which lower LDL cholesterol, have been a cornerstone of prevention for decades. They are often supplemented by other effective drugs, including ezetimibe, potent injectable PCSK9 inhibitors, and icosapent ethyl—a unique, purified omega-3 fatty acid. Each of these has been rigorously studied and recommended in clinical guidelines for specific high-risk patient groups.

However, real-world data paints a troubling picture of underutilization. Studies show that many high-risk patients fail to reach their target cholesterol levels on statins alone. Furthermore, even among patients treated with statins, the cumulative incidence of cardiovascular events can reach as high as 40% over a decade, highlighting a significant 'residual risk' that requires additional intervention. Despite this, few of these patients receive the evidence-based adjunct therapies recommended by medical societies.

This gap represents what Amarin calls “one of the largest, yet immediately fixable unmet needs in modern medicine.” The company is advocating for the healthcare community to “Review, Reassess, Refocus”: Review current prescribing patterns, Reassess the use of therapies that only improve lab numbers without proven event reduction, and Refocus on treatments backed by rigorous clinical outcome data.

A Strategic Call in a Competitive Market

While the public health message is compelling, Amarin’s call to action is also rooted in its own strategic interests. The company is the manufacturer of VASCEPA® (icosapent ethyl), a prescription-grade therapy proven in the large-scale REDUCE-IT trial to significantly reduce the risk of major adverse cardiovascular events in certain high-risk patients already on statins. As one of the key underutilized therapies, increased adoption directly benefits Amarin's bottom line.

The company has navigated a challenging market. Despite facing generic competition for icosapent ethyl in the United States, Amarin maintained over a 50% share of the market through late 2024. However, financial pressures are evident. The company reported a 17% decline in net revenue in the fourth quarter of 2024 compared to the previous year, with a net loss of $48.6 million. In response, Amarin is aggressively pursuing international expansion, securing reimbursement for its product, VAZKEPA®, in several European countries and gaining approval in China.

This advocacy campaign, therefore, serves a dual purpose. It addresses a legitimate and critical public health failure while simultaneously working to expand the market for its flagship product. By positioning itself as a leader in the fight against CVD undertreatment, Amarin aims to shift clinical practice toward the very class of adjunct therapies it provides, turning a public health crisis into a commercial opportunity.

Barriers to Care: Why Proven Treatments Don't Reach Patients

The reasons for the treatment gap are complex and multi-faceted, involving patients, physicians, and the healthcare system itself. For patients, medication adherence is a primary hurdle. Research indicates that up to 50% of patients with cardiovascular conditions do not take their medications as prescribed. Reasons range from simply forgetting and managing complex regimens with multiple pills to concerns about side effects and the financial burden of co-pays.

Low health literacy also plays a role; patients who do not fully grasp the silent, progressive nature of their disease may be less motivated to adhere to a lifelong treatment plan, especially when they feel healthy. Inadequate communication from healthcare providers can exacerbate this, leaving patients without the support and information needed to stay on track.

On the provider side, clinical inertia—a reluctance to intensify therapy even when treatment goals are not met—is a well-documented phenomenon. This can be driven by time constraints during appointments, concerns about polypharmacy, or a lack of familiarity with the latest guidelines for adjunct therapies. Systemic issues, including restrictive insurance formularies and reimbursement hurdles, can further limit access to newer or more expensive, albeit effective, treatments.

The Horizon of Innovation vs. The Urgency of Now

Looming on the horizon is a new wave of cardiovascular innovation that holds immense promise. Researchers are making significant strides in developing therapies that target novel pathways like APOC3, ANGPTL3, and the highly elusive Lp(a), a potent genetic risk factor for heart disease. Drugs in development, such as the RNA-based therapies olezarsen, plozasiran, and pelacarsen, have shown the ability to dramatically lower triglycerides and Lp(a) levels in clinical trials.

These future breakthroughs are essential for tackling residual risk and treating patient populations with limited options today. However, Amarin's message underscores a critical point: these innovations are still years away from broad clinical availability. Regulatory approval, reimbursement negotiations, and health system adoption are lengthy processes. The company argues that the medical community cannot afford to wait for tomorrow's solutions while patients remain at high risk today.

The immediate challenge, and opportunity, lies in closing the implementation gap. By systematically identifying high-risk patients and ensuring they receive the full benefit of currently available, guideline-recommended therapies, the healthcare system could prevent countless heart attacks and strokes. This requires a concerted effort from physicians, payers, and policymakers to prioritize data-driven care and overcome the barriers that stand between proven science and the patients who need it most.