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Cost effectiveness and screening interval of lipid screening in Hodgkins lymphoma survivors
Journal of Clinical Oncology, 09/17/09

Chen AB et al. – Lipid screening in survivors of HL, with statin therapy for screen-positive patients, improves survival and is cost effective. A screening interval of 3 years seems reasonable in the long-term follow-up of survivors of HL.

• Decision-analytic model
• Evaluated lipid screening in a hypothetical cohort of 30-year-old survivors of HL
• Survived 5 years after mediastinal irradiation.
• Compared following strategies: no screening, and screening at 1-, 3-, 5-, or 7-year intervals
• Screen-positive patients treated with statins
• Costs estimated from Medicare fee schedules and medical literature. Sensitivity analyses performed

• Using an incremental cost-effectiveness ratio (ICER) threshold of $100,000 per quality-adjusted life-year (QALY) saved, lipid screening at every interval was cost effective relative to strategy of no screening
• 3-year interval cost effective relative to a 5-year interval
• Annual screening, relative to screening every 3 years, had an ICER of more than $100,000/QALY saved
• Factors with most influence on results included risk of cardiac events/death after HL, efficacy of statins in reducing cardiac events/death, and costs of statins

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