title: Cost effectiveness analysis of a next generation risk assessment score for cardiovascular disease.
abstract: OBJECTIVE
  The goal of this study is to determine the cost-effectiveness of MIRISK VP, a next generation coronary heart disease risk assessment score, in correctly reclassifying and appropriately treating asymptomatic, intermediate risk patients.
  
  
  METHODS
  A Markov model was employed with simulated subjects based on the Multi-Ethnic Study of Atherosclerosis (MESA). This study evaluated three treatment strategies: (i) practice at MESA enrollment, (ii) current guidelines, and (iii) MIRISK VP in MESA.
  
  
  METHODS
  The model assessed patient healthcare costs and outcomes, expressed in terms of life years and quality-adjusted life years (QALYs), over the lifetime of the cohort from the provider and payer perspective. A total of 50,000 hypothetical individuals were used in the model. A sensitivity analysis was conducted (based on the various input parameters) for the entire cohort and also for individuals aged 65 and older.
  
  
  RESULTS
  Guiding treatment with MIRISK VP leads to the highest net monetary benefits when compared to the 'Practice at MESA Enrollment' or to the 'Current Guidelines' strategies. MIRISK VP resulted in a lower mortality rate from any CHD event and a modest increase in QALY of 0.12-0.17 years compared to the other two approaches.
  
  
  CONCLUSIONS
  This study has limitations of not comparing performance against strategies other than the FRS, the results are simulated as with all models, the model does not incorporate indirect healthcare costs, and the impact of patient or physician behaviors on outcomes were not taken into account.
  
  
  CONCLUSIONS
  MIRISK VP has the potential to improve patient outcomes compared to the alternative strategies. It is marginally more costly than both the 'Practice at MESA Enrollment' and the 'Current Guidelines' strategies, but it provides increased effectiveness, which leads to positive net monetary benefits over either strategy.
authors: Aviir, Inc. , Irvine, CA , USA.
authors: Evangelos
authors: E
authors: Hytopoulos
authors: Martin L
authors: ML
authors: Lee
authors: Michael
authors: M
authors: Beggs
authors: Cynthia
authors: C
authors: French
authors: Kuo Bianchini
authors: KB
authors: Tong
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000191:economics* / Q000453:epidemiology* / Q000401:mortality; D015897:Comorbidity; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D005260:Female; D005102:Health Expenditures; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology
chemical_list: D008055:Lipids