Synthesized economic evidence on the cost-effectiveness of screening familial hypercholesterolemia  

作　　者：Mengying Wang Shan Jiang Boyang Li Bonny Parkinson Jiao Lu Kai Tan Yuanyuan Gu Shunping Li 

机构地区：[1]School of Management,Shanxi Medical University,Taiyuan,Shanxi,China [2]Macquarie Business School and Australian Institute of Health Innovation,Macquarie University Centre for the Health Economy,Macquarie University,Level 5,75 Talavera Road,Macquarie Park,Sydney,NSW 2109,Australia [3]School of Political Science and Public Administration,Wuhan University,Wuhan,Hubei,China [4]School of Public Policy and Administration,Xi’an Jiaotong University,Xi’an,Shaanxi,China [5]Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan,Shandong,China [6]NHC Key Lab of Health Economics and Policy Research,Shandong University,Jinan,Shandong,China [7]Center for Health Preference Research,Shandong University,Jinan,Shandong,China

出　　处：《Global Health Research and Policy》2024年第1期190-206,共17页全球健康研究与政策(英文)

摘　　要：Background Familial hypercholesterolemia(FH)is a prevalent genetic disorder with global implications for severe cardiovascular diseases.Motivated by the growing recognition of the need for early diagnosis and treatment of FH to mitigate its severe consequences,alongside the gaps in understanding the economic implications and equity impacts of FH screening,this study aims to synthesize the economic evidence on the cost-effectiveness of FH screen-ing and to analyze the impact of FH screening on health inequality.Methods We conducted a systematic review on the economic evaluations of FH screening and extracted informa-tion from the included studies using a pre-determined form for evidence synthesis.We synthesized the cost-effective-ness components involving the calculation of synthesized incremental cost-effectiveness ratios(ICERs)and net health benefit(NHB)of different FH screening strategies.Additionally,we applied an aggregate distributional cost-effective-ness analysis(DCEA)to assess the impact of FH screening on health inequality.Results Among the 19 studies included,over half utilized Markov models,and 84%concluded that FH screening was potentially cost-effective.Based on the synthesized evidence,cascade screening was likely to be cost-effective,with an ICER of$49,630 per quality-adjusted life year(QALY).The ICER for universal screening was$20,860 per QALY as per evidence synthesis.The aggregate DCEA for six eligible studies presented that the incremental equally distrib-uted equivalent health(EDEH)exceeded the NHB.The difference between EDEH and NHB across the six studies were 325,137,556,36,50,and 31 QALYs,respectively,with an average positive difference of 189 QALYs.Conclusions Our research offered valuable insights into the economic evaluations of FH screening strategies,highlighting significant heterogeneity in methods and outcomes across different contexts.Most studies indicated that FH screening is cost-effective and contributes to improving overall population health while potentially reducing health in

关 键 词：Health economics COST-EFFECTIVENESS EQUITY Systematic review Familial hypercholesterolemia SCREENING 

分 类 号：R73[医药卫生—肿瘤]