Study Finds Widespread Screening for Rare Cholesterol Disorder Not Cost-Effective - News Center

"Screening all young people for a genetic form of dangerously high cholesterol could prevent heart attacks and strokes later in life, but would not be cost-effective under the current healthcare system, according to a new modelling study published in JAMA. Familial hypercholesterolemia (FH) is a genetic disorder that causes LDL (sometimes called "bad") cholesterol levels to be unusually high. The condition begins at birth and can cause heart attacks at an early age,"

""We've been struggling for a long time with how best to identify people with FH so that they can be treated early and aggressively," said Allen, who also directs the Center for Health Services & Outcomes Research within the Institute for Public Health and Medicine (IPHAM). "That's what this article is addressing: how to find this needle in the haystack, because while relatively few individuals have FH, they suffer major consequences.""

"First, investigators used an established cardiovascular disease policy model and estimated that under the status quo - where only occasional, opportunistic cholesterol testing occurs - all Americans from this simulated group would experience more than 3.1 million heart attacks and strokes. About 16,000 of those events would occur among people with FH, many of whom never know they have it."

Universal screening of young people for familial hypercholesterolemia (FH) would identify individuals with lifelong elevated LDL cholesterol who face early heart attack risk. Modeling estimated the status quo yields over 3.1 million heart attacks and strokes among the simulated population, with about 16,000 events among people with FH who are often undiagnosed. Simulations of a nationwide cohort of 4.2 million 10-year-olds showed routine cholesterol checks plus targeted genetic testing prevented between 1,150 and 1,820 cardiovascular events depending on LDL thresholds. The absolute reduction represented less than 0.1% of all projected events, and universal FH screening was not cost-effective under current healthcare conditions.

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