{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T21:48:44Z","timestamp":1781560124428,"version":"3.54.5"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Genomic and Precision Medicine"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Heterozygous familial hypercholesterolemia (HeFH) is under-detected and undertreated. A general practitioner-led screening and care program for HeFH effectively identified and managed patients with HeFH. We evaluated the cost-effectiveness and the return on investment of an enhanced-care strategy for HeFH in primary care in Australia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We developed a multistate Markov model to estimate the outcomes and costs of a general practitioner-led detection and management strategy for HeFH in primary care compared with the standard of care in Australia. The population comprised individuals aged 50 to 80 years, of which 44% had prior cardiovascular disease. Cardiovascular risk, HeFH prevalence, treatment effects, and acute and chronic health care costs were derived from published sources. The study involved screening for HeFH using a validated data-extraction tool (TARB-Ex), followed by a consultation to improve care. The detection rate of HeFH was 16%, and 74% of the patients achieved target LDL-C (low-density lipoprotein cholesterol). Quality-adjusted life years, health care costs, productivity losses, incremental cost-effectiveness ratio, and return on investment ratio were evaluated, outcomes discounted by 5% annually, adopting a health care and a societal perspective.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Over the lifetime horizon, the model estimated a gain of 870 years of life lived and 1033 quality-adjusted life years when the general practitioner-led program was employed compared with standard of care. This resulted in an incremental cost-effectiveness ratio of AU$14\u2009664\/quality-adjusted life year gained from a health care perspective. From a societal perspective, this strategy, compared with standard of care was cost-saving, with a return on investment of AU$5.64 per dollar invested.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>An enhanced general practitioner-led model of care for HeFH is likely to be cost-effective.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circgen.122.003842","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T09:01:45Z","timestamp":1681290105000},"page":"267-274","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Enhancing the Detection and Care of Heterozygous Familial Hypercholesterolemia in Primary Care: Cost-Effectiveness and Return on Investment"],"prefix":"10.1161","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-0374","authenticated-orcid":true,"given":"Clara","family":"Marquina","sequence":"first","affiliation":[{"name":"School of Public Health &amp; Preventive Medicine (C.M., J.M., M.L., E.Z.), Monash University."},{"name":"Centre for Medicine Use &amp; Safety, Faculty of Pharmacy &amp; Pharmaceutical Sciences (C.M., J.M., M.L., Z.A.), Monash University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3231-5758","authenticated-orcid":true,"given":"Jedidiah","family":"Morton","sequence":"additional","affiliation":[{"name":"School of Public Health &amp; Preventive Medicine (C.M., J.M., M.L., E.Z.), Monash University."},{"name":"Centre for Medicine Use &amp; Safety, Faculty of Pharmacy &amp; Pharmaceutical Sciences (C.M., J.M., M.L., Z.A.), Monash University."},{"name":"Baker Heart &amp; Diabetes Institute, Melbourne (J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4723-742X","authenticated-orcid":true,"given":"Tom","family":"Brett","sequence":"additional","affiliation":[{"name":"General Practice &amp; Primary Health Care Research, School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia (T.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3889-5458","authenticated-orcid":true,"given":"Melanie","family":"Lloyd","sequence":"additional","affiliation":[{"name":"School of Public Health &amp; Preventive Medicine (C.M., J.M., M.L., E.Z.), Monash University."},{"name":"Centre for Medicine Use &amp; Safety, Faculty of Pharmacy &amp; Pharmaceutical Sciences (C.M., J.M., M.L., Z.A.), Monash University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5751-0488","authenticated-orcid":true,"given":"Jan","family":"Radford","sequence":"additional","affiliation":[{"name":"Launceston Clinical School, University of Tasmania, Tasmania (J.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5041-2666","authenticated-orcid":true,"given":"Clare","family":"Heal","sequence":"additional","affiliation":[{"name":"Mackay Clinical School, James Cook University, Queensland (C. Heal)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4582-7728","authenticated-orcid":true,"given":"Charlotte","family":"Hespe","sequence":"additional","affiliation":[{"name":"School of Medicine, The University of Notre Dame Australia, Sydney, New South Wales (C. 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