Language
English
Publication Date
10-1-2025
Journal
Atherosclerosis
DOI
10.1016/j.atherosclerosis.2025.120447
PMID
41101894
Abstract
Background and aims: Cost-effectiveness of Lipoprotein(a) [Lp(a)] testing is not established. We aimed to evaluate the cost-effectiveness of Lp(a) testing in the cardiovascular disease (CVD) primary prevention population from healthcare and societal perspectives.
Methods: We constructed and validated a multi-state microsimulation Markov model for a population of 10,000 individuals aged between 40 and 69 years without CVD, selected randomly from the UK Biobank. The model evaluated Lp(a) testing in individuals not initially classified as high-risk based on age, diabetes status, or the SCORE-2 algorithm. Those with an Lp(a) level ≥105 nmol/L (50 mg/dL) were treated as high risk (initiation of a statin plus blood pressure lowering). The Lp(a) testing intervention was compared to standard of care. The primary analyses were conducted from the Australian and UK healthcare perspectives in 2023AUD/GBP. A cost adaptation method estimated cost-effectiveness in multiple European countries, Canada, and the USA.
Results: Among 10,000 individuals, 1,807 had their treatment modified from Lp(a) testing. This led to 217 and 255 quality-adjusted life years gained in Australia and the UK, respectively, with corresponding incremental cost-effectiveness ratios of 12,134 (cost-effective) and -3,491 (cost-saving). From a societal perspective, Lp(a) testing saved $85 and £263 per person in Australia and the UK, respectively. Lp(a) testing was cost-saving among all countries tested in the cost adaptation analysis.
Conclusions: Lp(a) testing in the primary prevention population to reclassify CVD risk and treatment is cost-saving and warranted to prevent CVD.
Keywords
Humans, Cost-Benefit Analysis, Cardiovascular Diseases, Lipoprotein(a), Primary Prevention, Middle Aged, Aged, Male, Female, Adult, Markov Chains, Quality-Adjusted Life Years, Biomarkers, Models, Economic, Developed Countries, Predictive Value of Tests, United Kingdom, Health Care Costs, Australia, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cost-Effectiveness Analysis
Published Open-Access
yes
Recommended Citation
Morton, Jedidiah I; Kronenberg, Florian; Daccord, Magdalena; et al., "Lp(a) Testing for the Primary Prevention of Cardiovascular Disease in High-Income Countries: A Cost-Effectiveness Analysis" (2025). Faculty, Staff and Students Publications. 6721.
https://digitalcommons.library.tmc.edu/baylor_docs/6721