Synthesized Economic Evidence on the Cost-effectiveness of Screening Familial Hypercholesterolemia: A meta-analytic review and Aggregate Distributional Cost-Effectiveness Analysis

BackgroundFamilial hypercholesterolemia (FH) is a prevalent genetic disorder with global implications for severe cardiovascular diseases. Amid ongoing advancements in genetic disease screening and treatment, the economic evaluation of FH is increasingly vital. Despite numerous studies, international disparities persist, necessitating a comprehensive analysis of the economic assessments of FH screening to provide valuable insights. This study aims to globally examine economic assessments of FH, synthesize evidence, and present economic insights into the impact of FH screening on population equity. MethodsSystematic literature analysis was used to systematically evaluate 19 FH screening economic evaluation studies and synthesize the evidence. Meta-analysis was used to comprehensively explore the total cost-effectiveness and total net health benefit of different FH screening methods. The aggregate Distributional Cost-Effectiveness Analysis (DCEA) was utilized to assess the impact of FH screening on population equity. ResultsThe study results reveal significant differences in the economic evaluations of FH across different countries, and we provide detailed descriptions of unique characteristics. The comprehensive results of cost-effectiveness analysis indicate that FH screening is cost-effective in the majority of countries. The meta-analysis synthesizes the economic impacts of Cascade Screening and Universal Screening across various health outcomes. Additionally, our aggregate Distributional Cost-Effectiveness Analysis (DCEA) suggests that FH screening strategies have the potential to alleviate health inequalities. ConclusionThis study provides a global perspective on FH economic evaluation. Despite international differences, findings suggest that, in the majority of cases, FH screening is cost-effective, improving health equity and overall population health. The study offers a positive outlook for future health decisions.