Health economic analysis of polygenic risk score use in primary prevention of coronary artery disease - A system...

Area of Science:

• Cardiovascular disease prevention
• Genomics in healthcare
• Health economics

Background:

• Traditional risk scores inadequately identify individuals at risk of acute cardiovascular events.
• There is a need to enhance primary prevention strategies for cardiovascular disease (CVD).

Purpose of the Study:

• To model the impact and cost-effectiveness of integrating Polygenic Risk Scores (PRS) into Australia's CVD primary prevention program.
• To assess the economic benefits of using PRS alongside traditional risk scores.

Main Methods:

• Utilized system dynamics models to simulate acute and chronic CVD care in Australia over a 10-year horizon.
• Assessed the cost-effectiveness of incorporating a Coronary Artery Disease PRS (CAD-PRS) in primary prevention.
• Modeled pragmatic integration of CAD-PRS for individuals at low/moderate risk via Heart Health Checks.

Main Results:

• Pragmatic CAD-PRS integration could prevent 2,052 deaths and gain 24,085 QALYs at $19,945/QALY, yielding a $724 million net benefit.
• Widespread use (all Australians >35) could prevent 12,374 deaths and 60,284 acute coronary events, gaining 183,682 QALYs at $18,531/QALY, with a $5.78 billion net benefit.

Conclusions:

• Incorporating CAD-PRS into Australian primary prevention offers significant health and economic advantages.
• Increased uptake of CAD-PRS in primary prevention leads to greater impact and cost-effectiveness.
• CAD-PRS represents a valuable tool for enhancing cardiovascular disease primary prevention strategies.