Table 3.
Costs, QALYs, NMBs and number of events per 1000 individuals for each CVD algorithm (including no algorithm) when a CVD risk threshold of 10% was employed
| Outcomes | Algorithm | ||||
| General lipid algorithm | SMI-specific lipid algorithm | General BMI algorithm | SMI-specific BMI algorithm | No algorithm | |
| Costs and QALYs, mean (95% CI) | |||||
| Costs of administering algorithm | 20 006 (19 906 to 20 106) | 20 006 (19 906 to 20 106) | 19 010 (18 935 to 19 085) | 19 010 (18 935 to 19 085) | n/a |
| Costs of new statin prescriptions | 38 371 (37 849 to 38 892) | 33 465 (33 012 to 33 919) | 31 611 (31 183 to 32 040) | 47 152 (46 510 to 47 794) | n/a |
| Costs of CVD events | 1 871 508 (1 698 400 to 2 044 617) | 1 882 462 (1 708 721 to 2 056 202) | 1 891 266 (1 717 495 to 2 065 038) | 1 855 697 (1 683 643 to 2 027 751) | 1 985 044 (1 807 487 to 2 162 602) |
| Total costs undiscounted | 1 929 885 (1 756 824 to 2 102 946) | 1 935 933 (1 762 235 to 2 109 631) | 1 941 887 (1 768 154 to 2 115 621) | 1 921 859 (1 749 857 to 2 093 861) | 1 985 044 (1 807 487 to 2 162 602) |
| Total costs discounted | 1 666 228 (1 515 958 to 1 816 499) | 1 671 497 (1 520 650 to 1 822 345) | 1 676 569 (1 525 676 to 1 827 462) | 1 659 340 (1 509 988 to 1 808 692) | 1 712 136 (1 557 767 to 1 866 506) |
| QALYs discounted | 6828 (6 813 to 6 843) | 6827 (6 812 to 6 842) | 6826 (6 811 to 6 841) | 6830 (6 815 to 6 845) | 6815 (6 800 to 6 831) |
| Cost compared with no algorithm | −45 908 | −40 639 | −35 567 | −52 797 | |
| QALYs compared with no algorithm | 13 | 12 | 11 | 15 | |
| Net monetary benefit, mean (95% CI) | |||||
| £20 000 WTP threshold | 134 898 309 (134 467 161 to 135 329 457) | 134 872 660 (134 439 483 to 135 305 838) | 134 841 184 (134 407 261 to 135 275 106) | 134 942 106 (134 513 538 to 135 370 673) | 134 593 353 (134 147 224 to 135 039 482) |
| £30 000 WTP threshold | 203 180 577 (202 601 927 to 203 759 228) | 203 144 739 (202 563 347 to 203 682 603) | 203 100 060 (202 517 517 to 203 682 603) | 203 242 828 (202 667 604 to 203 818 053) | 202 746 098 (202 146 930 to 1to 203 345 265) |
| Events, mean (95% CI) | |||||
| Primary non-fatal CHD | 81.87 (75.70 to 88.05) | 82.53 (76.33 to 88.74) | 82.98 (76.76 to 89.21) | 81.25 (75.14 to 87.37) | 87.57 (81.12 to 94.02) |
| Primary fatal CHD | 9.26 (8.56 to 9.95) | 9.33 (8.63 to 10.03) | 9.38 (8.68 to 10.09) | 9.18 (8.49 to 9.87) | 9.89 (9.16 to 10.62) |
| Primary non-fatal stroke | 104.18 (94.50 to 113.86) | 104.64 (94.93 to 114.35) | 104.92 (95.21 to 114.63) | 103.43 (93.80 to 113.06) | 108.77 (98.91 to 118.63) |
| Primary fatal stroke | 7.25 (6.56 to 7.93) | 7.27 (6.58 to 7.95) | 7.30 (6.62 to 7.99) | 7.18 (6.50 to 7.85) | 7.55 (6.86 to 8.24) |
| Secondary non-fatal CVD | 14.77 (13.73 to 15.81) | 14.97 (13.92 to 16.03) | 15.15 (14.09 to 16.21) | 14.48 (13.46 to 15.50) | 17.20 (16.03 to 18.38) |
| Secondary fatal CVD | 6.53 (6.10 to 6.96) | 6.64 (6.20 to 7.07) | 6.65 (6.22 to 7.09) | 6.41 (5.99 to 6.83) | 7.78 (7.28 to 8.27) |
| Death from other causes | 119.43 (118.63 to 120.24) | 119.40 (118.59 to 120.21) | 119.35 (118.55 to 120.16) | 119.40 (118.59 to 120.20) | 119.05 (118.25 to 119.85) |
Discounted costs and QALYs reflect time preference for current benefits over future ones.
BMI, body mass index; CHD, coronary heart disease; CVD, cardiovascular disease; NMB, net monetary benefit; QALYs, quality-adjusted life years; SMI, severe mental illness; WTP, willingness to pay.