Health economic analysis of polygenic risk score use in primary prevention of coronary artery disease – A system dynamics model

Stephen T. Vernon, Stuart Brentnall, Danielle J. Currie, Cindy Peng, Michael P. Gray, Giordano Botta, Deo Mujwara, Stephen J. Nicholls, Stuart M. Grieve, Julie Redfern, Clara Chow, Jean Frederic Levesque, Peter J. Meikle, Garry Jennings, Zanfina Ademi, Andrew Wilson, Gemma A. Figtree*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

2 Downloads (Pure)

Abstract

Background: 

Primary prevention programs utilising traditional risk scores fail to identify all individuals who suffer acute cardiovascular events. We aimed to model the impact and cost effectiveness of incorporating a Polygenic risk scores (PRS) into the cardiovascular disease CVD primary prevention program in Australia, using a whole-of-system model. 

Methods: 

System dynamics models, encompassing acute and chronic CVD care in the Australian healthcare setting, assessing the cost-effectiveness of incorporating a CAD-PRS in the primary prevention setting. The time horizon was 10-years. 

Results: 

Pragmatically incorporating a CAD-PRS in the Australian primary prevention setting in middle-aged individuals already attending a Heart Health Check (HHC) who are determined to be at low or moderate risk based on the 5-year Framingham risk score (FRS), with conservative assumptions regarding uptake of PRS, could have prevented 2, 052 deaths over 10-years, and resulted in 24, 085 QALYs gained at a cost of $19, 945 per QALY with a net benefit of $724 million. If all Australians overs the age of 35 years old had their FRS and PRS performed, and acted upon, 12, 374 deaths and 60, 284 acute coronary events would be prevented, with 183, 682 QALYs gained at a cost of $18, 531 per QALY, with a net benefit of $5, 780 million. 

Conclusions: 

Incorporating a CAD-PRS in a contemporary primary prevention setting in Australia would result in substantial health and societal benefits and is cost-effective. The broader the uptake of CAD-PRS in the primary prevention setting in middle-aged Australians, the greater the impact and the more cost-effective the strategy.

Original languageEnglish
Article number100672
Pages (from-to)1-7
Number of pages7
JournalAmerican Journal of Preventive Cardiology
Volume18
DOIs
Publication statusPublished - Jun 2024
Externally publishedYes

Fingerprint

Dive into the research topics of 'Health economic analysis of polygenic risk score use in primary prevention of coronary artery disease – A system dynamics model'. Together they form a unique fingerprint.

Cite this