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Screening for hypercholesterolemia among Canadians: how much will it cost?
S A Grover1, L Coupal, R Fahkry
1Centre for Cardiovascular Risk Assessment, Montreal General Hospital, Que.
Summary
Screening all Canadians over 30 for hypercholesterolemia could identify millions at high risk. The estimated first-year cost ranges from $432 to $561 million, requiring careful economic evaluation.
Area of Science:
- Public Health
- Health Economics
- Cardiovascular Disease Prevention
Background:
- Hypercholesterolemia is a significant risk factor for coronary heart disease (CHD).
- Nationwide screening strategies require robust cost-benefit analyses.
- Assessing the economic feasibility of widespread health interventions is crucial.
Purpose of the Study:
- To estimate the cost of a universal hypercholesterolemia screening program for Canadians aged 30 and above.
- To determine the potential number of individuals identified at various risk levels for CHD.
Main Methods:
- Utilized 1986 Canadian census and 1978 Canada Health Survey data for initial screening estimates.
- Employed Lipid Research Clinics Prevalence Study data for repeat testing estimations.
- Extrapolated lipid profile results from clinical chemistry laboratory data and incorporated cost data from professional societies and fee schedules.
Main Results:
- Screening 12,479,356 Canadians without CHD would identify 48.7% at high risk, 4.8% at moderate risk, and 46.6% at low risk.
- The first-year implementation cost is estimated between $432 million and $561 million.
- Laboratory tests account for $325 million, with practitioner visits costing an additional $107 million to $236 million.
Conclusions:
- A nationwide hypercholesterolemia screening program presents substantial initial costs.
- The economic feasibility and practical benefits must be carefully weighed before implementation.
- Cost-effectiveness evaluations are essential for public health policy decisions regarding cardiovascular risk screening.