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Comparing costs and benefits over a 10 year period of strategies for familial hypercholesterolaemia screening

Marks, D; Thorogood, M; Neil, HAW; Wonderling, D; Humphries, SE; (2003) Comparing costs and benefits over a 10 year period of strategies for familial hypercholesterolaemia screening. J PUBLIC HEALTH MED , 25 (1) 47 - 52. 10.1093/pubmed/fdg010.

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Abstract

Background Approximately 110 000 people in the United Kingdom are affected with familial hypercholesterolaemia (FH). At least 75 per cent are undiagnosed. Treatment with statins is effective but effective primary prevention requires early diagnosis. The best strategy to achieve this is unclear. This paper compares the costs and benefits over a 10 year period of two strategies found in our previous modelling: population screening of 16-year-olds or tracing family members of affected patients.Methods Computer modelling of time-limited data was conducted. The number available for screening and the potential new cases in England and Wales aged 16-54 years were estimated. The costs (of screening and treatment) and benefits (deaths averted) that might be accrued over 10 years were assessed.Results Screening 16-year-olds results in 470 new diagnoses, and over 10 subsequent years averts 11.7 deaths at a cost of pound6 176 649, giving a cost per case identified and treated of pound13 141 (including a 10 year drug cost of pound1 584 918). By contrast, screening first-degree relatives of known cases results in 13 248 new diagnoses, 560 deaths averted over 10 years, at a cost of pound46 430 681, giving a cost per case identified and treated of pound3 505 (including 10 year drug cost of pound44 645 760). The cost per death averted would be pound3 187.Conclusions Although the two approaches appear similar in cost-effectiveness over a lifetime, the shorter-term (10 year) cost-effectiveness clearly favours family tracing. This represents good value for money compared with common medical interventions, and suggests that pilot FH family tracing programmes should be conducted.

Type:Article
Title:Comparing costs and benefits over a 10 year period of strategies for familial hypercholesterolaemia screening
DOI:10.1093/pubmed/fdg010
Keywords:familial hypercholesterolaemia, screening, costs, benefits, AVERAGE CHOLESTEROL LEVELS, CORONARY-HEART-DISEASE, RANDOMIZED-TRIAL, GENERAL-PRACTICE, PRIMARY-CARE, INDIVIDUALS, SIMVASTATIN, INTERVENTIONS, PRAVASTATIN, MANAGEMENT
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science

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