Cost-effectiveness analysis in diagnosis of coronary artery disease: choice of laboratory markers.
OBJECTIVE
The aim of our study was to determine the cost-effectiveness of coronary artery disease (CAD) diagnostic parameters in a clinical laboratory setting.


METHODS
The effectiveness of apolipoproteins, lipoproteins and high sensitivity C-reactive protein (hs-CRP) supplementary to Framingham scoring data within a CAD risk assessment procedure was established in 221 CAD patients and 289 controls. The total costs of diagnostic procedures were calculated and incremental cost-effectiveness analysis was applied.


RESULTS
A diagnostic strategy employing Framingham calculation followed by apolipoprotein A-I (apoA-I) had the lowest cost per additional successfully diagnosed patient than the same strategy followed by hs-CRP in the low (2.63 vs. 24.47 euros) and intermediate-risk groups (2.96 vs. 122.85 euros). In the high-risk group the diagnostic strategy employing apoA-I saved 9.14 euros in comparison to the strategy employing hs-CRP.


CONCLUSIONS
Cost-effectiveness analysis of different diagnostic markers results in improved identification of at-risk patients at a lower health cost for society.
Bogavac-Stanojević
Natasa
N
Institute of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia. naca@pharmacy.bg.ac.yu
Ivanova Petrova
Guenka
G
Jelić-Ivanović
Zorana
Z
Memon
Lidija
L
Spasić
Slavica
S
D000328:Adult; D001053:Apolipoproteins / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000191:economics; D003362:Cost-Benefit Analysis / Q000379:methods; D003935:Diagnostic Techniques, Cardiovascular / Q000191:economics*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
D001053:Apolipoproteins; D015415:Biomarkers; D008055:Lipids; D008074:Lipoproteins; D002097:C-Reactive Protein