Cost-effectiveness analysis of implementing polygenic risk score in a workplace cardiovascular disease prevention program
BackgroundPolygenic risk score for coronary artery disease (CAD-PRS) improves precision in assessing the risk of cardiovascular diseases and is cost-effective in preventing cardiovascular diseases in a health system and may be cost-effective in other settings and prevention programs such as workplac...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1139496/full |
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| author | Deo Mujwara Jen Kintzle Paolo Di Domenico George B. Busby Giordano Bottà |
| author_facet | Deo Mujwara Jen Kintzle Paolo Di Domenico George B. Busby Giordano Bottà |
| author_sort | Deo Mujwara |
| collection | DOAJ |
| description | BackgroundPolygenic risk score for coronary artery disease (CAD-PRS) improves precision in assessing the risk of cardiovascular diseases and is cost-effective in preventing cardiovascular diseases in a health system and may be cost-effective in other settings and prevention programs such as workplace cardiovascular prevention programs. Workplaces provide a conducitve environment for cardiovascular prevention interventions, but the cost-effectiveness of CAD-PRS in a workplace setting remains unknown. This study examined the cost-effectiveness of integrating CAD-PRS in a workplace cardiovascular disease prevention program compared to the standard cardiovascular workplace program without CAD-PRS and no-workplace prevention program.MethodsWe developed a cohort simulation model to project health benefits (quality-adjusted life years gained) and costs over a period of 5 years in a cohort of employees with a mean age of 50 years. The model health states reflected the risk of disease (coronary artery disease and ischemic stroke) and statin prevention therapy side effects (diabetes, hemorrhagic stroke, and myopathy). We considered medical and lost productivity costs. Data were obtained from the literature, and the analysis was performed from a self-insured employer perspective with future costs and quality-adjusted life years discounted at 3% annually. Uncertainty in model parameter inputs was assessed using deterministic and probabilistic sensitivity analyses. Three programs were compared: (1) a workplace cardiovascular program that integrated CAD-PRS with the pooled cohort equation—a standard of care for assessing the risk of cardiovascular diseases (CardioriskSCORE); (2) a workplace cardiovascular prevention program without CAD-PRS (Standard-WHP); and (3) no-workplace health program (No-WHP). The main outcomes were total costs (US $2019), incremental costs, incremental quality-adjusted life years, and incremental cost-effectiveness ratio.ResultsCardioriskSCORE lowered employer costs ($53 and $575) and improved employee quality-adjusted life years (0.001 and 0.005) per employee screened compared to Standard-WHP and No-WHP, respectively. The effectiveness of statin prevention therapy, employees' baseline cardiovascular risk, the proportion of employees that enrolled in the program, and statin adherence had the largest effect size on the incremental net monetary benefit. However, despite the variation in parameter input values, base case results remained robust.ConclusionPolygenic testing in a workplace cardiovascular prevention program improves employees' quality of life and simultaneously lowers health costs and productivity monetary loss for employers. |
| first_indexed | 2024-03-13T00:26:05Z |
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| id | doaj.art-4dedb1f00d8e477baa3ce09d9f1aa9bf |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-13T00:26:05Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Public Health |
| spelling | doaj.art-4dedb1f00d8e477baa3ce09d9f1aa9bf2023-07-11T04:48:57ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-07-011110.3389/fpubh.2023.11394961139496Cost-effectiveness analysis of implementing polygenic risk score in a workplace cardiovascular disease prevention programDeo MujwaraJen KintzlePaolo Di DomenicoGeorge B. BusbyGiordano BottàBackgroundPolygenic risk score for coronary artery disease (CAD-PRS) improves precision in assessing the risk of cardiovascular diseases and is cost-effective in preventing cardiovascular diseases in a health system and may be cost-effective in other settings and prevention programs such as workplace cardiovascular prevention programs. Workplaces provide a conducitve environment for cardiovascular prevention interventions, but the cost-effectiveness of CAD-PRS in a workplace setting remains unknown. This study examined the cost-effectiveness of integrating CAD-PRS in a workplace cardiovascular disease prevention program compared to the standard cardiovascular workplace program without CAD-PRS and no-workplace prevention program.MethodsWe developed a cohort simulation model to project health benefits (quality-adjusted life years gained) and costs over a period of 5 years in a cohort of employees with a mean age of 50 years. The model health states reflected the risk of disease (coronary artery disease and ischemic stroke) and statin prevention therapy side effects (diabetes, hemorrhagic stroke, and myopathy). We considered medical and lost productivity costs. Data were obtained from the literature, and the analysis was performed from a self-insured employer perspective with future costs and quality-adjusted life years discounted at 3% annually. Uncertainty in model parameter inputs was assessed using deterministic and probabilistic sensitivity analyses. Three programs were compared: (1) a workplace cardiovascular program that integrated CAD-PRS with the pooled cohort equation—a standard of care for assessing the risk of cardiovascular diseases (CardioriskSCORE); (2) a workplace cardiovascular prevention program without CAD-PRS (Standard-WHP); and (3) no-workplace health program (No-WHP). The main outcomes were total costs (US $2019), incremental costs, incremental quality-adjusted life years, and incremental cost-effectiveness ratio.ResultsCardioriskSCORE lowered employer costs ($53 and $575) and improved employee quality-adjusted life years (0.001 and 0.005) per employee screened compared to Standard-WHP and No-WHP, respectively. The effectiveness of statin prevention therapy, employees' baseline cardiovascular risk, the proportion of employees that enrolled in the program, and statin adherence had the largest effect size on the incremental net monetary benefit. However, despite the variation in parameter input values, base case results remained robust.ConclusionPolygenic testing in a workplace cardiovascular prevention program improves employees' quality of life and simultaneously lowers health costs and productivity monetary loss for employers.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1139496/fullcost-effectivenesspolygenic risk score (PRS)cardiovasccular risk factorsworkplace settingprevention |
| spellingShingle | Deo Mujwara Jen Kintzle Paolo Di Domenico George B. Busby Giordano Bottà Cost-effectiveness analysis of implementing polygenic risk score in a workplace cardiovascular disease prevention program Frontiers in Public Health cost-effectiveness polygenic risk score (PRS) cardiovasccular risk factors workplace setting prevention |
| title | Cost-effectiveness analysis of implementing polygenic risk score in a workplace cardiovascular disease prevention program |
| title_full | Cost-effectiveness analysis of implementing polygenic risk score in a workplace cardiovascular disease prevention program |
| title_fullStr | Cost-effectiveness analysis of implementing polygenic risk score in a workplace cardiovascular disease prevention program |
| title_full_unstemmed | Cost-effectiveness analysis of implementing polygenic risk score in a workplace cardiovascular disease prevention program |
| title_short | Cost-effectiveness analysis of implementing polygenic risk score in a workplace cardiovascular disease prevention program |
| title_sort | cost effectiveness analysis of implementing polygenic risk score in a workplace cardiovascular disease prevention program |
| topic | cost-effectiveness polygenic risk score (PRS) cardiovasccular risk factors workplace setting prevention |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1139496/full |
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