Key result
Lp(a) testing for CVD risk reclassification is cost-saving and prevents events in primary prevention.
Why the study?
Cost-effectiveness of Lipoprotein(a) testing for primary prevention of cardiovascular disease is not established.
Is Lp(a) testing cost-effective for the primary prevention of cardiovascular disease in individuals not initially classified as high-risk?
Is Lp(a) testing cost-effective for the primary prevention of cardiovascular disease in individuals not initially classified as high-risk?
Answers are grounded in this paper and cite their sources.
Lp(a) testing in primary prevention populations to reclassify CVD risk and guide treatment is cost-saving and warranted to prevent CVD in high-income countries.
BACKGROUND AND AIMS: Cost-effectiveness of Lipoprotein(a) [Lp(a)] testing is not established. We aimed to evaluate the cost-effectiveness of Lp(a) testing in the cardiovascular disease (CVD) primary prevention population from healthcare and societal perspectives. METHODS: We constructed and validated a multi-state microsimulation Markov model for a population of 10,000 individuals aged between 40 and 69 years without CVD, selected randomly from the UK Biobank. The model evaluated Lp(a) testing in individuals not initially classified as high-risk based on age, diabetes status, or the SCORE-2 algorithm. Those with an Lp(a) level ≥105 nmol/L (50 mg/dL) were treated as high risk (initiation of a statin plus blood pressure lowering). The Lp(a) testing intervention was compared to standard of care. The primary analyses were conducted from the Australian and UK healthcare perspectives in 2023AUD/GBP. A cost adaptation method estimated cost-effectiveness in multiple European countries, Canada, and the USA. RESULTS: Among 10,000 individuals, 1,807 had their treatment modified from Lp(a) testing. This led to 217 and 255 quality-adjusted life years gained in Australia and the UK, respectively, with corresponding incremental cost-effectiveness ratios of 12,134 (cost-effective) and -3,491 (cost-saving). From a societal perspective, Lp(a) testing saved $85 and £263 per person in Australia and the UK, respectively. Lp(a) testing was cost-saving among all countries tested in the cost adaptation analysis. CONCLUSIONS: Lp(a) testing in the primary prevention population to reclassify CVD risk and treatment is cost-saving and warranted to prevent CVD.
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Morton et al. (2025) studied cardiovascular disease primary prevention (n=10,000). Lp(a) testing vs. standard of care was evaluated on cost-effectiveness (incremental cost-effectiveness ratio). Lp(a) testing for primary CVD prevention was cost-effective or cost-saving compared to standard care, yielding 217 and 255 QALYs gained per 10,000 individuals in Australia and the UK.
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