EFFICIENCY AND COST-EFFECTIVENESS OF DYSLIPIDEMIA SCREENING METHODS AMONG WORKERS IN BANGKOK

Dyslipidemia is now a worldwide health problem. Secondary prevention in the form of early detection of dyslipidemia and risk modification via drug and non-drug procedures, particularly among the high-risk group, is thus imperative. The objective of this study was to determine the sensitivity and specificity, cost, and cost-effectiveness of dyslipidemia screening methods which were proposed by the Royal Thai Medical Association (RTMA), the United States National Cholesterol Education Program (NCEP), British Hyperlipidemia Association (BHA), and our modified screening instrument (MSI). A cross-sectional descriptive study was conducted among 2,000 workers aged ≥ 35 years taking annual health examination from a university hospital during July- September, 2008. Sensitivity and specificity of the screening methods were analyzed using the universal serum lipid testing as the gold standard. Their total and unit costs, and cost-effectiveness were then calculated. Overall, the sensitivities for detecting any type of serum lipid abnormalities ranged between 29.9-99.4 %, while the specificities ranged between 0.5-74.1%. The total costs per 1,000 people screened ranged between THB 88,742 -184,750. No screening method was obviously more cost-effective when using the cost per case detected of the universal blood test as the reference.