[Cost-effectiveness analysis of a genetic screening program in the close relatives of Spanish patients with familial hypercholesterolemia].
OBJECTIVE
The aim was to assess the cost-effectiveness of a genetic screening program for first-degree relatives of patients with familial hypercholesterolemia (FH), followed by treatment when necessary, compared with the alternative of no screening.


METHODS
The cost-effectiveness analysis modeled the effect of statin treatment on individuals who were diagnosed with FH after genetic screening. The impact of uncertainty was evaluated using univariate probabilistic sensitivity analysis. The alternate strategy considered was no screening. In the cost-effectiveness analysis, the number of life-years gained (LYG) was regarded as the health outcome and the costs of screening, statin treatment, specialist consultations and hospital visits were all included. In addition, the expected value of perfect information was calculated as part of the sensitivity analysis.


RESULTS
In the base case, the incremental cost of the screening program for close relatives was 3423 euros per LYG. Although the sensitivity analysis gave a range of results, the conclusions were not affected by changes in the parameters considered. The screening program was found to be better than the alternative considered at a probability level of 95% if the acceptable level of health-care costs was at least 7400 euros per LYG.


CONCLUSIONS
This analysis indicates that a genetic screening program, supplemented by treatment, for the close relatives of individuals with FH is preferable to the alternative of no screening in terms of incremental cost-effectiveness.
Oliva
Juan
J
Universidad de Castilla-La Mancha, Toledo, Spain. juan.olivamoreno@uclm.es
López-Bastida
Julio
J
Moreno
Santiago G
SG
Mata
Pedro
P
Alonso
Rodrigo
R
D000328:Adult; D000367:Age Factors; D003362:Cost-Benefit Analysis; D005190:Family; D005260:Female; D005820:Genetic Testing / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D006937:Hypercholesterolemia / Q000191:economics / Q000453:epidemiology* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D013030:Spain / Q000453:epidemiology; D055815:Young Adult