COST-EFFECTIVENESS AND BUDGET IMPACT ANALYSES OF RISK STRATIFICATION OF PATIENTS WITH MODERATE RISK OF CARDIOVASCULAR EVENTS USING LP-PLA2 TESTING
Author(s)
Rinde H1, Genser B2, Sonntag D2, Kleber ME2, Stojakovic T3, Scharnagl H3, Maerz W4
1BioBridge Strategies, Binningen, Switzerland, 2Mannheim Institue of Public Health, Social and Preventive Medicine, Mannheim, Germany, 3Medical University of Graz, Graz, Austria, 4Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
OBJECTIVES: would improve clinical and economic outcomes vs. ESC-SCORE alone in Germany for 50-70 year-olds. 2) Evaluate the potential budget impact for payers. METHODS: To decide the treatment strategy for patients with moderate risk for cardiovascular events is a challenge. They would usually not receive statin treatment in Germany. For further risk stratification there is a need to identify patients with vulnerable plaques. When an arterial plaque becomes unstable Lp-PLAis released, which indicate that these patients could benefit from treatment to prevent future cardiovascular events. An integrated cost-effectiveness and budget impact model was constructed. Lp-PLAincreased the adjusted risk for CVD events in the moderate ESC-SCORE population by >2 fold in the German LURIC Study Cohort (HR 2.23, 95% CI 1.15-4.32; P= 0.018). Efficacy of statin treatment relevant costs were obtained from literature. A range of sensitivity analyses were performed. RESULTS: The cost-effectiveness and the budget impact analyses used a theoretical population of 1 million, of which 14% were 50-70 year olds with moderate cardiovascular risk. The total 10-year discounted and adherence adjusted net cost savings from implementing the Lp-PLA testing strategy was €19 million, or €156 per Lp-PLAtested patient. The 10-year accumulated number of deaths averted by the Lp-PLA testing strategy was 611, or 17 incremental discounted life-days and 2.2 incremental discounted event-free life-months per Lp-PLAtested patient. Projected to whole of Germany’s population aged 50-70 the potential annual discounted savings from the Lp-PLAtesting strategy would be €180 million. The potential number of deaths averted per year would be 5,030. CONCLUSIONS: Our results indicate that the Lp-LPA testing strategy is both cost saving and provide reduction in mortality and morbidity. The implementation of Lp-LPA testing strategy should be considered in Germany.
Conference/Value in Health Info
2014-11, ISPOR Europe 2014, Amsterdam, The Netherlands
Value in Health, Vol. 17, No. 7 (November 2014)
Code
PCV49
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis, Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Cardiovascular Disorders