Omega-3 Fatty Acid Supplements vs. Prescription Versions: Here’s What You Need To Know


There’s a reason why almost everyone fishes for the seafood section of a menu card: the swimmingly good health benefits of omega-3 fatty acids, of course! Derived primarily from fish and marine oil, omega-3 Polyunsaturated Fatty Acid (Fish Oil) supplements are often touted for a variety of benefits including reducing inflammation, improving mental health, benefiting the digestive function, blood lipid management, and even cancer prevention.

However, health practitioners have often wondered how fish oil supplements compare with prescription fish oils like Vascepa and Lovaza. Read on to know why it should matter to you.

fish oil softgels

There’s nothing fishy about the fact that omega-3 rich fatty acid has compelling health benefits!

Why do we need research on omega-3 fatty acid?

From lowering blood pressure and reducing the likelihood of cardiovascular incidents, the many health benefits of omega-3 fatty acid — also referred to as “n-3s”— supplements are relatively well known (read more about the supplement that makes you shine here). This is the reason why health practitioners have been keen to jump onto the research that delves deeper into the world of omega-3 fatty acid and the highly touted benefits of fish oil.

In doing so, they have unearthed a refreshing finding. Omega-3 fatty acid rich supplements are — in some cases — comparable to the relatively more expensive prescription versions of the famed fatty acids.

Take ConsumerLab.com’s research as an example: they posted a review in which they tested 28 popular omega-3 fatty acid supplements made from fish, krill, algal, sea buckthorn, and calamari oils. The testing assessed EPA and DHA content, DPA and omega-7s content, and contaminants such as arsenic, cadmium, lead, and mercury.

Three products were identified as having discrepancies in one or more of these criteria. Of the products that passed tests, top picks were selected for regular softgels, enteric-coated softgels, and liquids. You can read more about various supplement forms here.

Of particular interest, the report found that some supplement products with very high concentrations of EPA and/or DHA were comparable to (significantly) more expensive prescription omega-3 drugs, such as Epanova (500-600mg EPA / 150-250mg DHA), Lovaza (465mg EPA / 375mg DHA) and Vascepa (960mg EPA / < 40mg DHA).

This is significant given that so many people are turning to omega-3 fatty acid supplements, be it for regulating triglyceride (blood fat) levels, countering depression, ADHD, easing rheumatoid arthritis, and so much more.

Fish oils are currently recommended by the American Heart Association for use as a secondary line of treatment in patients with extremely high triglyceride levels (greater than 1000 mg/dL). (1) The recommended treatment dose for treating hypertriglyceridemia specifically is 2-5 grams of combined EPA and DHA per day. (2)

Fish oil: understanding the different forms of omega-3 fatty acid

Prescription omega-3 fatty acid products are all somewhat different in form. Lovaza and Vascepa contain fatty acids in ethyl ester form (the most common form in supplements), whereas the fatty acids in Epanova are in “free fatty acid” form, a novel form claimed to be more bioavailable by its producer, AstraZeneca.

The report does compare different forms of extracts such as ethyl ester, natural triglyceride, and re-esterified triglyceride. It points out some studies that found re-esterified triglyceride form had a bioavailability almost 76% better than ethyl ester form, and 34% better than the natural triglyceride form. (3)

The Ethyl ester form is by far the most researched. It is considered safe, and both Lovaza and Vascepa are made from it. What’s interesting is that there may be promise for a new form of omega-3 fatty acid supplements, likely to be far less expensive compared to their oft-prescribed counterparts.

Did you know?
Vascepa is the only prescription product listed here that has been approved in a large, well-controlled clinical trial to reduce the risk of cardiovascular disease. (2)

However, also of note is that the annual cost of Vascepa is approximately USD$3,000.00, or USD$250.00 per month!

This gap in the cost to benefit analysis is likely a reason for both health practitioners and consumers of fish oil to pay heed to the report.

Ultimately, the report indicated that omega-3 fatty acid supplements in equivalent dosing are potentially a more cost-effective alternative to prescription medications like Epanova, Lovaza, and Vascepa. The report further summarizes the clinical evidence for and against fish oil supplementation, indicates the dosage for specific uses, and explains potential side effects and drug interactions for omega-3 fatty acid supplements. To view the full report, visit ConsumerLab.

There’s nothing fishy about the fact that omega-3 rich fatty acid has compelling health benefits! But if there’s room for both innovation and cost efficiency in the supplements, we win, both as practitioners and as consumers.

For more information about fish oil supplements, check out extensive blog post on the subject!

  1. Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association. 1. Circulation. 2017 Apr 11;135(15):e867-e884. Doi: 10.1161/CIR.0000000000000482.
  2. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia
    Deepak L. Bhatt, M.D., M.P.H., P. Gabriel Steg, M.D., Michael Miller, M.D., Eliot A. Brinton, M.D., Terry A. Jacobson, M.D., Steven B. Ketchum, Ph.D., Ralph T. Doyle, Jr., B.A., Rebecca A. Juliano, Ph.D., Lixia Jiao, Ph.D., Craig Granowitz, M.D., Ph.D., Jean-Claude Tardif, M.D., and Christie M. Ballantyne, M.D. for the REDUCE-IT Investigators*N Engl J Med 2019; 380:11-22 DOI: 10.1056/NEJMoa1812792
  3. Bioavailability of marine n-3 fatty acid formulations.
    Dyerberg J1, Madsen P, Møller JM, Aardestrup I, Schmidt EB. PMID: 20638827 DOI: 10.1016/j.plefa.2010.06.007