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The reduced cost of providing a nationally recognised service for familial hypercholesterolaemia

Robert Pears1, Michael Griffin2, Melanie Watson3

  • 1Department of Public Health , Hampshire County Council , Winchester , UK.

Open Heart
|October 22, 2014
PubMed

Insights

Implementing new models of care for Familial Hypercholesterolaemia (FH) significantly reduces costs. A dual-care model, with general practitioners (GPs) managing patients and specialist support, offers substantial savings for FH services.

Area of Science:

  • Cardiovascular Medicine
  • Health Economics
  • Genetics

Background:

  • Familial Hypercholesterolaemia (FH) is a prevalent genetic disorder affecting 1 in 500 UK individuals, significantly increasing coronary heart disease risk.
  • Despite National Institute for Health and Care Excellence (NICE) recommendations for genetic testing and cascade screening since 2008, implementation has been slow due to perceived costs.
  • Evidence supports the cost-effectiveness and clinical benefits of FH services, yet commissioners have been hesitant.

Purpose of the Study:

  • To quantify the reduced costs of providing a Familial Hypercholesterolaemia (FH) service utilizing generic atorvastatin.
  • To compare the National Institute for Health and Care Excellence (NICE) costing estimates with three alternative models of care.
  • To assess the long-term cost-effectiveness of FH service delivery.

Main Methods:

  • A 10-year costing model was developed, revising the existing NICE 3-year template.
  • Costs were projected for the first population-based FH service in England (SHIP population: 1.95 million).
  • Analysis included the impact of generic atorvastatin, reduced DNA testing costs, and shifts in care management.

Main Results:

  • The cost of a 10-year FH service in the SHIP region decreased by 42.5% (£4.88 million to £2.80 million) after the atorvastatin patent expiry.
  • Further cost reductions are achievable through lower DNA testing expenses, increased general practice management, and reduced specialist referrals.
  • A dual-care model, integrating GP management with specialist support, demonstrated a projected cost of £1.89 million.

Conclusions:

  • The three alternative care models evaluated are less than 50% of the original NICE cost estimates.
  • Implementing these innovative models can significantly improve the economic viability of FH services.
  • These findings support the wider adoption of cost-effective strategies for managing Familial Hypercholesterolaemia.
Abstract

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