Cargando…
The reduced cost of providing a nationally recognised service for familial hypercholesterolaemia
OBJECTIVE: Familial hypercholesterolaemia (FH) affects 1 in 500 people in the UK population and is associated with premature morbidity and mortality from coronary heart disease. In 2008, National Institute for Health and Care Excellence (NICE) recommended genetic testing of potential FH index cases...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189221/ https://www.ncbi.nlm.nih.gov/pubmed/25332782 http://dx.doi.org/10.1136/openhrt-2013-000015 |
_version_ | 1782338327559536640 |
---|---|
author | Pears, Robert Griffin, Michael Watson, Melanie Wheeler, Rebecca Hilder, Debbie Meeson, Beverley Bacon, Sallie Byrne, Christopher D |
author_facet | Pears, Robert Griffin, Michael Watson, Melanie Wheeler, Rebecca Hilder, Debbie Meeson, Beverley Bacon, Sallie Byrne, Christopher D |
author_sort | Pears, Robert |
collection | PubMed |
description | OBJECTIVE: Familial hypercholesterolaemia (FH) affects 1 in 500 people in the UK population and is associated with premature morbidity and mortality from coronary heart disease. In 2008, National Institute for Health and Care Excellence (NICE) recommended genetic testing of potential FH index cases and cascade testing of their relatives. Commissioners have been slow to respond although there is strong evidence of cost and clinical effectiveness. Our study quantifies the recent reduced cost of providing a FH service using generic atorvastatin and compares NICE costing estimates with three suggested alternative models of care (a specialist-led service, a dual model service where general practitioners (GPs) can access specialist advice, and a GP-led service). METHODS: Revision of existing 3 year costing template provided by NICE for FH services, and prediction of costs for running a programme over 10 years. Costs were modelled for the first population-based FH service in England which covers Southampton, Hampshire, Isle of Wight and Portsmouth (SHIP). Population 1.95 million. RESULTS: With expiry of the Lipitor (Pfizer atorvastatin) patent the cost of providing a 10-year FH service in SHIP reduces by 42.5% (£4.88 million on patent vs £2.80 million off patent). Further cost reductions are possible as a result of the reduced cost of DNA testing, more management in general practice, and lower referral rates to specialists. For instance a dual-care model with GP management of patients supported by specialist advice when required, costs £1.89 million. CONCLUSIONS: The three alternative models of care are now <50% of the cost of the original estimates undertaken by NICE. |
format | Online Article Text |
id | pubmed-4189221 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-41892212014-10-20 The reduced cost of providing a nationally recognised service for familial hypercholesterolaemia Pears, Robert Griffin, Michael Watson, Melanie Wheeler, Rebecca Hilder, Debbie Meeson, Beverley Bacon, Sallie Byrne, Christopher D Open Heart Health Care Delivery, Economics and Global Health Care OBJECTIVE: Familial hypercholesterolaemia (FH) affects 1 in 500 people in the UK population and is associated with premature morbidity and mortality from coronary heart disease. In 2008, National Institute for Health and Care Excellence (NICE) recommended genetic testing of potential FH index cases and cascade testing of their relatives. Commissioners have been slow to respond although there is strong evidence of cost and clinical effectiveness. Our study quantifies the recent reduced cost of providing a FH service using generic atorvastatin and compares NICE costing estimates with three suggested alternative models of care (a specialist-led service, a dual model service where general practitioners (GPs) can access specialist advice, and a GP-led service). METHODS: Revision of existing 3 year costing template provided by NICE for FH services, and prediction of costs for running a programme over 10 years. Costs were modelled for the first population-based FH service in England which covers Southampton, Hampshire, Isle of Wight and Portsmouth (SHIP). Population 1.95 million. RESULTS: With expiry of the Lipitor (Pfizer atorvastatin) patent the cost of providing a 10-year FH service in SHIP reduces by 42.5% (£4.88 million on patent vs £2.80 million off patent). Further cost reductions are possible as a result of the reduced cost of DNA testing, more management in general practice, and lower referral rates to specialists. For instance a dual-care model with GP management of patients supported by specialist advice when required, costs £1.89 million. CONCLUSIONS: The three alternative models of care are now <50% of the cost of the original estimates undertaken by NICE. BMJ Publishing Group 2014-08-12 /pmc/articles/PMC4189221/ /pubmed/25332782 http://dx.doi.org/10.1136/openhrt-2013-000015 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/ |
spellingShingle | Health Care Delivery, Economics and Global Health Care Pears, Robert Griffin, Michael Watson, Melanie Wheeler, Rebecca Hilder, Debbie Meeson, Beverley Bacon, Sallie Byrne, Christopher D The reduced cost of providing a nationally recognised service for familial hypercholesterolaemia |
title | The reduced cost of providing a nationally recognised service for familial hypercholesterolaemia |
title_full | The reduced cost of providing a nationally recognised service for familial hypercholesterolaemia |
title_fullStr | The reduced cost of providing a nationally recognised service for familial hypercholesterolaemia |
title_full_unstemmed | The reduced cost of providing a nationally recognised service for familial hypercholesterolaemia |
title_short | The reduced cost of providing a nationally recognised service for familial hypercholesterolaemia |
title_sort | reduced cost of providing a nationally recognised service for familial hypercholesterolaemia |
topic | Health Care Delivery, Economics and Global Health Care |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189221/ https://www.ncbi.nlm.nih.gov/pubmed/25332782 http://dx.doi.org/10.1136/openhrt-2013-000015 |
work_keys_str_mv | AT pearsrobert thereducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT griffinmichael thereducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT watsonmelanie thereducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT wheelerrebecca thereducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT hilderdebbie thereducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT meesonbeverley thereducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT baconsallie thereducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT byrnechristopherd thereducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT pearsrobert reducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT griffinmichael reducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT watsonmelanie reducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT wheelerrebecca reducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT hilderdebbie reducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT meesonbeverley reducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT baconsallie reducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia AT byrnechristopherd reducedcostofprovidinganationallyrecognisedserviceforfamilialhypercholesterolaemia |