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NICE analysis casts doubt on CVD screening plans

By Nigel Praities

The Government's planned cardiovascular screening programme will be far less cost-effective than an approach based on GP records, according to detailed economic modelling released by NICE.

The analysis found using existing information on GP databases to estimate risk and prioritise patients was more than three times as cost effective as screening everyone over a certain age.

The Department of Health announced in April that all patients aged 40 to 74 would be invited in for a vascular check from next year, but the evidence base for this approach has been criticised by experts.

The NICE model found using GP practice data to prioritise 20% of the patient population was a cost-effective way of targeting those at risk and increasing life expectancy, at £3,960 per quality-adjusted life-year.

In contrast, screening everyone aged over 50 years and then all those over 40 years cost £12,222 per QALY.

The authors concluded GP records were good enough to use to prioritise patients.

‘Primary prevention of CVD should make use of strategies to prioritise patients at highest risk and invite patients in descending order of CVD risk estimated from data in the GP database. UK general practices have enough data to do this systematically,' found the analysis.

Dr Stewart Findlay, treasurer of the Primary Care Cardiovascular Society and a GP in Bishop Auckland, County Durham, said this showed the Government's plans for primary prevention should be phased in. ‘Quite clearly we should make sure those at highest risk are our first priority,' he said.

Pulse last month exclusively revealed the national cardiovascular screening programme would be phased in more slowly than planned because of concern over the burden on GPs.

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