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  • Špacírová, ZuzanaCIBER Epidemiology and Public Health (CIBERESP),Andalusian School Of Public Health (EASP) (author)

The cost-effectiveness of a uniform versus age-based threshold for one-off screening for prevention of cardiovascular disease

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • 2022-10-14
  • Springer Science and Business Media LLC,2023

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:e9c2be31-933f-4b53-a51f-c96ddcdc867d
  • https://lup.lub.lu.se/record/e9c2be31-933f-4b53-a51f-c96ddcdc867dURI
  • https://doi.org/10.1007/s10198-022-01533-yDOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • The objective of this article was to assess the cost-effectiveness of screening strategies for cardiovascular diseases (CVD). A decision analytic model was constructed to estimate the costs and benefits of one-off screening strategies differentiated by screening age, sex and the threshold for initiating statin therapy (“uniform” or “age-adjusted”) from the Spanish NHS perspective. The age-adjusted thresholds were configured so that the same number of people at high risk would be treated as under the uniform threshold. Health benefit was measured in quality-adjusted life years (QALY). Transition rates were estimated from the European Prospective Investigation into Cancer and Nutrition (EPIC-CVD), a large multicentre nested case-cohort study with 12 years of follow-up. Unit costs of primary care, hospitalizations and CVD care were taken from the Spanish health system. Univariate and probabilistic sensitivity analyses were employed. The comparator was no systematic screening program. The base case model showed that the most efficient one-off strategy is to screen both men and women at 40 years old using a uniform risk threshold for initiating statin treatment (Incremental Cost-Effectiveness Ratio of €3,274/QALY and €6,085/QALY for men and women, respectively). Re-allocating statin treatment towards younger individuals at high risk for their age and sex would not offset the benefit obtained using those same resources to treat older individuals. Results are sensitive to assumptions about CVD incidence rates. To conclude, one-off screening for CVD using a uniform risk threshold appears cost-effective compared with no systematic screening. These results should be evaluated in clinical studies.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Kaptoge, Stephen (author)
  • García-Mochón, LeticiaCIBER Epidemiology and Public Health (CIBERESP),Andalusian School Of Public Health (EASP) (author)
  • Rodríguez Barranco, MiguelAndalusian School Of Public Health (EASP),CIBER Epidemiology and Public Health (CIBERESP) (author)
  • Sánchez Pérez, María JoséUniversity of Granada,Andalusian School Of Public Health (EASP),CIBER Epidemiology and Public Health (CIBERESP) (author)
  • Bondonno, Nicola P.Edith Cowan University,Danish Cancer Society (author)
  • Tjønneland, AnneDanish Cancer Society,University of Copenhagen (author)
  • Weiderpass, ElisabeteInternational Agency for Research on Cancer, World Health Organization (author)
  • Grioni, SaraIstituto Nazionale dei Tumori (author)
  • Espín, JaimeAndalusian School Of Public Health (EASP),CIBER Epidemiology and Public Health (CIBERESP) (author)
  • Sacerdote, CarlottaCitta' della Salute e della Scienza Hospital-University of Turin (author)
  • Schiborn, CatarinaGerman Center for Diabetes Research,German Institute of Human Nutrition (author)
  • Masala, GiovannaInstitute for Cancer Research, Prevention and Clinical Network (ISPRO) (author)
  • Colorado-Yohar, Sandra M.University of Antioquia,CIBER Epidemiology and Public Health (CIBERESP),Murcia Regional Health Council (author)
  • Kim, Lois (author)
  • Moons, Karel G.M.University Medical Center Utrecht (author)
  • Engström, GunnarLund University,Lunds universitet,Kardiovaskulär forskning - epidemiologi,Forskargrupper vid Lunds universitet,Cardiovascular Research - Epidemiology,Lund University Research Groups(Swepub:lu)smi-gen (author)
  • Schulze, Matthias B.German Institute of Human Nutrition,German Center for Diabetes Research,University of Potsdam (author)
  • Bresson, Léa (author)
  • Moreno-Iribas, ConcepciónHealth Research Institute of Navarra (IDISNA) (author)
  • Epstein, DavidUniversity of Granada,Health Research Institute of Navarra (IDISNA) (author)
  • CIBER Epidemiology and Public Health (CIBERESP)Andalusian School Of Public Health (EASP) (creator_code:org_t)

Related titles

  • In:European Journal of Health Economics: Springer Science and Business Media LLC24:7, s. 1033-10451618-75981618-7601

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