Canadian Cost-Effectiveness of Coronary Artery Calcium Screening Based on the Multi-Ethnic Study of Atherosclerosis
Authors' conclusion
CAC score-guided statin initiation in comparison to universal statin treatment was borderline cost-neutral at 5 years and cost-effective at 10 years in statin-eligible Canadian patients at intermediate cardiovascular disease risk.
Study context
- Population
- Intermediate-risk, primary prevention patients eligible for statins (Canada; MESA data)
- Comparison
- Coronary artery calcium (CAC) score-guided statin treatment vs universal statin therapy
- Outcome
- Incremental cost-effectiveness ratio (<$50,000 per QALY gained considered cost-effective)
- Follow-up
- 5 and 10 years
Methodological detailsstate transition microsimulation model, sensitivity analyses
- State transition microsimulation model
- Sensitivity analyses
Main finding
As reported in the abstract
Cost per QALY gained (ICER)
- 5 years
- cost per quality-adjusted life year (QALY) gained $54,492 (95% CI $52,342-$56,816)
- 10 years
- cost per QALY gained $8,118 (95% CI $7,968-$8,279)
- 5 years
- increase in mean costs $326 (95% CI $325-$326)
- 10 years
- increase in mean costs $172 (95% CI $169-$175)
- 5 years
- increase in mean QALYs 0.01 QALYs (95% CI 0.01–0.01)
- 10 years
- increase in mean QALYs 0.02 QALYs (95% CI 0.02–0.02)
Further findings
Sensitivity analyses
- Model most sensitive to statin cost, CAC testing cost, adherence to statin monitoring, and disutility of daily statin use
- At 5 years, CAC-guided treatment cost-effective when CAC test costs ranged $80 to $160 in different scenarios
Original publication
Canadian Cost-Effectiveness of Coronary Artery Calcium Screening Based on the Multi-Ethnic Study of Atherosclerosis. JACC Adv. Published 6 March 2024. doi:10.
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