Sequential Screening for Heterozygous Familial Hypercholesterolemia Not Cost-Effective

WEDNESDAY, Nov. 19, 2025 (HealthDay News) -- Sequential screening for heterozygous familial hypercholesterolemia (FH) in childhood or early adulthood can be effective but is not cost-effective compared with usual care, according to a study published online Nov. 9 in the Journal of the American Medical Association.Brandon K. Bellows, Pharm.D., from the Columbia University Irving Medical Center in New York City, and colleagues examined the projected cost-effectiveness of population sequential FH screening at age 10 or 18 years. Lifetime health and economic outcomes were simulated from a health care sector perspective for a hypothetical cohort of 4.2 million 10-year-olds.The researchers found that usual care would result in 3,118,000 total lifetime cardiovascular disease (CVD) events for the simulated cohort, with 16,182 events among those with FH. Between 1,385 and 1,820 and between 1,154 and 1,448 CVD events could be averted with childhood and early adulthood FH screening, respectively (<0.1 percent reduction for both). Relative to usual care, no FH screening strategies were cost-effective, although they were effective. The lowest incremental cost-effectiveness ratio was seen with screening at age 18 years using a low-density lipoprotein cholesterol (LDL-C) threshold of 190 mg/dL or greater, at $289,700 per quality-adjusted life-year gained. If lifetime lipid monitoring plus lifestyle therapy increased after a high screening LDL-C result, sequential FH screening could become cost-effective versus usual care, including for patients with non-FH dyslipidemias."Because of the high upfront costs of screening millions to find a relatively small number of people with FH genes, our modeling found that none of the combined cholesterol plus genetic screening strategies were cost-effective compared to usual care," senior author Andrew E. Moran, M.D., M.P.H., from the Columbia University Vagelos College of Physicians and Surgeons, said in a statement.Several authors disclosed ties to the biopharmaceutical and medical technology industries.Abstract/Full TextEditorial.Sign up for our weekly HealthDay newsletter

Sequential Screening for Heterozygous Familial Hypercholesterolemia Not Cost-Effective

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