Health Policy Manag.  2019 Sep;29(3):357-367. 10.4332/KJHPA.2019.29.3.357.

Cost-Effectiveness Analysis for National Dyslipidemia Screening Program in Korea: Results of Best Case Scenario Analysis Using a Markov Model

Affiliations
  • 1Department of Health Administration, Dankook University College of Health Science, Cheonan, Korea.
  • 2Institute of Health Promotion and Policy, Dankook University, Cheonan, Korea.
  • 3Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 4Institute of Health Services Research, Yonsei University, Seoul, Korea. soheepark@yuhs.ac
  • 5Department of Hospital Management, Yonsei University Graduate School of Public Health, Seoul, Korea.
  • 6Department of Biostatistics, Yonsei University Graduate School of Public Health, Seoul, Korea.

Abstract

BACKGROUND
This study evaluated the cost-effectiveness of 21 different national dyslipidemia screening strategies according to total cholesterol (TC) cutoff and screening interval among 40 years or more for the primary prevention of coronary heart disease over a lifetime in Korea, from a societal perspective.
METHODS
A decision tree was used to estimate disease detection with the 21 different screening strategies, while a Markov model was used to model disease progression until death, quality-adjusted life years (QALYs) and costs from a Korea societal perspective.
RESULTS
The results showed that the strategy with TC 200 mg/dL and 4-year interval cost ₩4,625,446 for 16.65105 QALYs per person and strategy with TC 200 mg/dL and 3-year interval cost ₩4,691,771 for 16.65164 QALYs compared with ₩3,061,371 for 16.59877 QALYs for strategy with no screening. The incremental cost-effectiveness ratio of strategy with TC 200 mg/dL and 4-year interval versus strategy with no screening was ₩29,916,271/QALY. At a Korea willingness-to-pay threshold of ₩30,500,000/QALY, strategy with TC 200 mg/dL and 4-year interval is cost-effective compared with strategy with no screening. Sensitivity analyses showed that results were robust to reasonable variations in model parameters.
CONCLUSION
In this study, revised national dyslipidemia screening strategy with TC 200 mg/dL and 4-year interval could be a cost-effective option. A better understanding of the Korean dyslipidemia population may be necessary to aid in future efforts to improve dyslipidemia diagnosis and management.

Keyword

Cost; Dyslipidemia; Effectiveness; Screening

MeSH Terms

Cholesterol
Coronary Disease
Cost-Benefit Analysis*
Decision Trees
Diagnosis
Disease Progression
Dyslipidemias*
Humans
Korea*
Mass Screening*
Primary Prevention
Quality-Adjusted Life Years
Cholesterol
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