Health economic evaluation of screening and treating children with familial hypercholesterolemia early in life: Many happy returns on investment?

Atherosclerosis
Zanfina AdemiGerald F Watts

Abstract

There are no studies that have specifically investigated the cost-effectiveness of cascade screening of children for heterozygous familial hypercholesterolemia (FH) and treatment of affected individuals with statins to prevent coronary heart disease (CHD). This study explores the cost-effectiveness of this strategy from the perspective of the Australian public healthcare system. A lifetime Markov model with four health states (Alive without CHD, Alive with CHD, Dead from fatal CHD, and Dead from other causes) was developed to simulate the progression of ten-year-old children screened for FH and treated immediately with statins if found to have FH. The underlying prevalence of FH in this target population was assumed to be 56.8%, and the sensitivity and specificity of testing were 100%. The comparator was usual care, which assumed that subjects started statins spontaneously at a later point or when they experienced a cardiovascular event. The effect of reducing low-density lipoprotein cholesterol (LDL-C) on the risk of a first event at each age assumed that risk was proportional to total lifetime exposure and was implemented using Mendelian randomisation analysis data. Cost and other outcome data were sourced from published sour...Continue Reading

Citations

Sep 2, 2020·Current Atherosclerosis Reports·Jing PangGerald F Watts
Jun 14, 2021·The Lancet Child & Adolescent Health·M Doortje ReijmanAlbert Wiegman
Aug 28, 2021·European Journal of Human Genetics : EJHG·Alexandra CernatWendy J Ungar

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