Economic evaluation of screening for familiar form of arrhythmogenic right ventricular cardiomyopathy in Poland.
BACKGROUND
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a myocardial disease associated with fibrofatty tissue replacement in heart muscle leading to arrhythmia, heart failure or sudden death (SCD) often being the first manifestation in probands. At least 50% of cases of ARVC are inherited.


OBJECTIVE
To evaluate costs and cost-effectiveness of diagnosis of the disease in asymptomatic relatives in Poland.


METHODS
239 asymptomatic subjects (mean age 35 years, 120 male) belonging to 42 families affected with ARVC were examined between May 2003 and May 2005. The costs of outpatient visits and additional diagnostic tests were included. Payer perspective was used.


RESULTS
In all individuals ECG and transthoracic echocardiography were performed. Magnetic resonance imaging and signal-averaged ECG were performed in 35 patients suspected of having ARVC. The diagnostic criteria for ARVC were fulfilled in 29 patients and 57 subjects were recognised borderline. Total costs of screening amounted to 71 090 PLN (approximately 20,000 euro). The average cost per one case of detected ARVC was 2451 PLN (approximately 680 euro).


CONCLUSIONS
Costs of early detection of ARVC in individuals with a family history of the disease in Polish settings are low. Due the avilability of primary prevention of SCD the family screening in asymptomatic subjects is a cost-effective procedure.
Kowalik
Ewa
E
Klinika Wad Wrodzonych Serca, Instytut Kardiologii, ul. Alpejska 42, 04-628 Warszawa. ewa.kowalik@gmail.com
Włodarska
Elzbieta K
EK
Woźniak
Olgierd
O
Hoffman
Piotr
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000175:diagnosis* / Q000235:genetics; D009202:Cardiomyopathies / Q000175:diagnosis; D003362:Cost-Benefit Analysis; D004452:Echocardiography / Q000191:economics; D004562:Electrocardiography / Q000191:economics; D005192:Family Health; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D011044:Poland