(Lee KK, Cipriano LE, Owens DK, Go AS, Hlatky MA. Cost-effectiveness of using high sensitivity C-reactive protein to identify intermediate and low cardiovascular risk individuals for statin therapy. Circulation. 2010 Oct 12. In Press.)
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The online calculator seeks to help decision-makers identify the optimal cost effective policy for hs-CRP screening and statin therapy in intermediate and low risk adults with an LDL cholesterol less than 130 mg/dl.
The online calculator is based on a published decision-analytic Markov model (http://weblink to article). This model includes all costs, regardless of who accrues them (patients or their health insurer), and projects the life-time benefits, harms, and costs of each strategy. The "optimal strategy" provides the greatest benefit with an incremental cost effectiveness ratio compared to the next best strategy less than the maximum willingness to pay threshold of $50,000 per quality-adjusted life-year (QALY) gained.
Age: 40, 45, 50, 55, 60, 65, or 70
Gender: Male or female
Risk factors: None, hypertension only, smoking and hypertension
Statin Effect by hs-CRP level
Quality of life decrement from statin therapy
Total cholesterol: 186 mg/dL
LDL cholesterol: 108 mg/dL
Statin cost: $1.10 per day
No increased risk of diabetes from statin treatment
The calculator identifies the policy that is optimally cost effective from the societal perspective for a cohort of patients with the selected characteristics at a willingness to pay threshold of $50,000 per QALY-gained. The calculator does not identify the optimal strategy for an individual patient.