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The cost-effectiveness analysis of coronary artery disease diagnostic parameters in a clinical laboratory setting

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2007
The_cost_effectiveness_pub_2007.pdf (76.48Kb)
Authors
Bogavac-Stanojević, Nataša
Petrova, Guenka
Jelić-Ivanović, Zorana
Memon, Lidija
Spasić, Slavica
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Abstract
OBJECTIVES: The aim of this study was to analyse the cost- effectiveness of consecutive supplementing of the Framingham scoring (FRS) algorithm for coronary artery disease (CAD) risk assessment with apolipoproteins B and A-I (apoA-I and apoB), the apo (a) phenotype, lipoprotein (a), and high sensitivity C- reactive protein (hs-CRP). The perspective of the analysis is the clinical laboratory setting. METHODS: The study is prospective diagnosing of 221 CAD patients and 289 controls. First line testing followed the guidelines for risk assessment based on FRS. Risk factors included in the FRS are: age, total cholesterol, high density cholesterol, systolic blood pressure, treatment for hyper- tension and cigarette smoking. FRS classifies individuals into those with 10-year risk for CAD of >20% event risk (high risk group), 10–20% event risk (intermediate risk group) and <10% event risk (low risk group). The FRS algorithm was supple- mented with apolipoproteins, lipoproteins a...nd hs-CRP and the effectiveness was measured in number needed to diagnose (NND). Total cost of diagnostic procedure was calculated on the basis of the consumed resources for diagnostic tests, labor time, and consumables. To evaluate the additional number needed to be diagnosed for successful CAD risk establishment was per- formed and incremental cost-effectiveness analysis. RESULTS: A diagnostic strategy employing FRS followed by apoA-I had lowest cost per additionally successfully diagnoses patient than the same strategy followed by hs-CRP in the low (2.63 vs. 24.47 euros) and intermediate risk groups (2.93 vs. 122.86 euros). In the high-risk group the diagnostic strategy employing apo A-I was the cost-effective strategy. It had a lower ICER (-9.14 euros) than the strategy employing hs-CRP (7.16 euros). CONCLUSION: Cost-effectiveness analysis of different diagnostic markers results in improved identification of at-risk patients at a lower health cost for society. In the clinical laboratory setting it is sufficient to determine apoA-I concentration in addition to FRS for CAD risk assessment.

Source:
Value in Health, 2007, 10, 6, A414-A414
Publisher:
  • Elsevier

DOI: 10.1016/S1098-3015(10)65444-7

ISSN: 1098-3015

WoS: 000251508900602

[ Google Scholar ]
URI
https://farfar.pharmacy.bg.ac.rs/handle/123456789/900
Collections
  • Radovi istraživača / Researchers’ publications
Institution/Community
Pharmacy
TY  - CONF
AU  - Bogavac-Stanojević, Nataša
AU  - Petrova, Guenka
AU  - Jelić-Ivanović, Zorana
AU  - Memon, Lidija
AU  - Spasić, Slavica
PY  - 2007
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/900
AB  - OBJECTIVES: The aim of this study was to analyse the cost-
effectiveness of consecutive supplementing of the Framingham
scoring (FRS) algorithm for coronary artery disease (CAD) risk
assessment with apolipoproteins B and A-I (apoA-I and apoB),
the apo (a) phenotype, lipoprotein (a), and high sensitivity C-
reactive protein (hs-CRP). The perspective of the analysis is the
clinical laboratory setting. METHODS: The study is prospective
diagnosing of 221 CAD patients and 289 controls. First line
testing followed the guidelines for risk assessment based on FRS.
Risk factors included in the FRS are: age, total cholesterol, high
density cholesterol, systolic blood pressure, treatment for hyper-
tension and cigarette smoking. FRS classifies individuals into
those with 10-year risk for CAD of >20% event risk (high risk
group), 10–20% event risk (intermediate risk group) and <10%
event risk (low risk group). The FRS algorithm was supple-
mented with apolipoproteins, lipoproteins and hs-CRP and the
effectiveness was measured in number needed to diagnose
(NND). Total cost of diagnostic procedure was calculated on the
basis of the consumed resources for diagnostic tests, labor time,
and consumables. To evaluate the additional number needed to
be diagnosed for successful CAD risk establishment was per-
formed and incremental cost-effectiveness analysis. RESULTS:
A diagnostic strategy employing FRS followed by apoA-I had
lowest cost per additionally successfully diagnoses patient than
the same strategy followed by hs-CRP in the low (2.63 vs. 24.47
euros) and intermediate risk groups (2.93 vs. 122.86 euros). In
the high-risk group the diagnostic strategy employing apo A-I
was the cost-effective strategy. It had a lower ICER (-9.14 euros)
than the strategy employing hs-CRP (7.16 euros). CONCLUSION: Cost-effectiveness analysis of different diagnostic markers
results in improved identification of at-risk patients at a lower
health cost for society. In the clinical laboratory setting it is
sufficient to determine apoA-I concentration in addition to FRS
for CAD risk assessment.
PB  - Elsevier
C3  - Value in Health
T1  - The cost-effectiveness analysis of coronary artery disease diagnostic parameters in a clinical laboratory setting
VL  - 10
IS  - 6
SP  - A414
EP  - A414
DO  - 10.1016/S1098-3015(10)65444-7
ER  - 
@conference{
author = "Bogavac-Stanojević, Nataša and Petrova, Guenka and Jelić-Ivanović, Zorana and Memon, Lidija and Spasić, Slavica",
year = "2007",
abstract = "OBJECTIVES: The aim of this study was to analyse the cost-
effectiveness of consecutive supplementing of the Framingham
scoring (FRS) algorithm for coronary artery disease (CAD) risk
assessment with apolipoproteins B and A-I (apoA-I and apoB),
the apo (a) phenotype, lipoprotein (a), and high sensitivity C-
reactive protein (hs-CRP). The perspective of the analysis is the
clinical laboratory setting. METHODS: The study is prospective
diagnosing of 221 CAD patients and 289 controls. First line
testing followed the guidelines for risk assessment based on FRS.
Risk factors included in the FRS are: age, total cholesterol, high
density cholesterol, systolic blood pressure, treatment for hyper-
tension and cigarette smoking. FRS classifies individuals into
those with 10-year risk for CAD of >20% event risk (high risk
group), 10–20% event risk (intermediate risk group) and <10%
event risk (low risk group). The FRS algorithm was supple-
mented with apolipoproteins, lipoproteins and hs-CRP and the
effectiveness was measured in number needed to diagnose
(NND). Total cost of diagnostic procedure was calculated on the
basis of the consumed resources for diagnostic tests, labor time,
and consumables. To evaluate the additional number needed to
be diagnosed for successful CAD risk establishment was per-
formed and incremental cost-effectiveness analysis. RESULTS:
A diagnostic strategy employing FRS followed by apoA-I had
lowest cost per additionally successfully diagnoses patient than
the same strategy followed by hs-CRP in the low (2.63 vs. 24.47
euros) and intermediate risk groups (2.93 vs. 122.86 euros). In
the high-risk group the diagnostic strategy employing apo A-I
was the cost-effective strategy. It had a lower ICER (-9.14 euros)
than the strategy employing hs-CRP (7.16 euros). CONCLUSION: Cost-effectiveness analysis of different diagnostic markers
results in improved identification of at-risk patients at a lower
health cost for society. In the clinical laboratory setting it is
sufficient to determine apoA-I concentration in addition to FRS
for CAD risk assessment.",
publisher = "Elsevier",
journal = "Value in Health",
title = "The cost-effectiveness analysis of coronary artery disease diagnostic parameters in a clinical laboratory setting",
volume = "10",
number = "6",
pages = "A414-A414",
doi = "10.1016/S1098-3015(10)65444-7"
}
Bogavac-Stanojević, N., Petrova, G., Jelić-Ivanović, Z., Memon, L.,& Spasić, S.. (2007). The cost-effectiveness analysis of coronary artery disease diagnostic parameters in a clinical laboratory setting. in Value in Health
Elsevier., 10(6), A414-A414.
https://doi.org/10.1016/S1098-3015(10)65444-7
Bogavac-Stanojević N, Petrova G, Jelić-Ivanović Z, Memon L, Spasić S. The cost-effectiveness analysis of coronary artery disease diagnostic parameters in a clinical laboratory setting. in Value in Health. 2007;10(6):A414-A414.
doi:10.1016/S1098-3015(10)65444-7 .
Bogavac-Stanojević, Nataša, Petrova, Guenka, Jelić-Ivanović, Zorana, Memon, Lidija, Spasić, Slavica, "The cost-effectiveness analysis of coronary artery disease diagnostic parameters in a clinical laboratory setting" in Value in Health, 10, no. 6 (2007):A414-A414,
https://doi.org/10.1016/S1098-3015(10)65444-7 . .

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