Clinical Scorecard: A Decade of Cardiovascular Disease Expenses in Genetically Confirmed Familial Hypercholesterolaemia Compared to Age- and Sex-Matched Controls

At a Glance

Key Highlights

• Patients with FH had approximately three times higher cardiovascular disease-related hospital costs than age- and sex-matched controls over 10 years.
• Pharmaceutical costs related to cardiovascular disease were more than 10 times higher in FH patients compared to controls, with a notable increase due to PCSK9 inhibitors.
• During 2010–2019, pharmaceutical costs increased while hospital care costs decreased in both FH and control populations.

Guideline-Based Recommendations

Diagnosis

• Genetic testing for LDL receptor gene variants to confirm familial hypercholesterolaemia.

Management

• Use of diet and lipid-lowering medications to reduce LDL-cholesterol and atherosclerosis risk.
• Incorporation of proprotein convertase subtilisin/kexin Type 9 (PCSK9) inhibitors as part of pharmaceutical treatment.

Monitoring & Follow-up

• Regular follow-up of cardiovascular disease-related hospitalizations and pharmaceutical treatments using comprehensive health registries.

Risks

• Increased risk of premature cardiovascular disease including acute myocardial infarction, aortic stenosis, peripheral artery disease, atrial fibrillation, and heart failure.

Patient & Prescribing Data

Individuals with genetically verified familial hypercholesterolaemia in Norway

Pharmaceutical costs doubled over 10 years largely due to introduction of PCSK9 inhibitors; statins and other lipid-lowering therapies are standard.

Clinical Best Practices

• Early genetic diagnosis of FH to enable timely intervention.
• Comprehensive use of lipid-lowering therapies including newer agents like PCSK9 inhibitors to manage elevated LDL-cholesterol.
• Utilization of national health registries for monitoring resource use and outcomes.
• Consideration of cost implications in treatment planning and healthcare policy.

References

• Norwegian Unit for Cardiac and Cardiovascular Genetics registry
• Norwegian Patient Registry
• Norwegian Prescription Database