An Evaluation of the Cost-effectiveness of Comprehensive MTM Integrated with Point-of-Care Phenotypic and Genetic Testing for U.S. Elderly Patients After Percutaneous Coronary Intervention

Abstract

No outside funding supported this study. The authors have no conflicts of interest to declare. Study concept and design were contributed by Okere and Diaby. Ezendu took the lead in data collection, along with Okere. Data interpretation was performed by all the authors. The manuscript was written by Okere, Diaby, and Berthe and revised by Okere and Diaby.

Systematic review of the evidence on the cost-effectiveness of pharmacogenomics-guided treatment for cardiovascular diseases

“…This review included all studies targeting patients internationally, which allowed us to have a broader view to examine potential differences due to geography and national policy. [44][45][46][47] We focused on PGx testing with an actionable gene-drug relationship used to guide treatment decisions, making this review of evidence useful for clinical practice and medical decision making.…”

Community-Based Services by Pharmacists: A Systematic Review of Cost-Utility Analyses

“…Overall, 29 articles were included in this review, which were published between 1999 and 2018. Most of these studies were conducted in the United Kingdom (n = 5), [16][17][18][19][20] followed by Canada (n = 4), [21][22][23][24] the United States (n = 3), [25][26][27] The Netherlands (n = 2), 28,29 Spain (n = 2), 30,31 Belgium (n = 1), 32 France (n = 1), 33 Italy (n = 1), 34 and Brazil (n = 1). 35…”

“…Seven (35%) of 20 studies focused on medication review involving monitoring of medication use, assessing appropriateness of prescribing, and providing feedback to prescribing physicians (if needed) intended to minimize errors and optimize pharmacotherapy. 16,18,27,29,30,32,34 Seven (35%) studies focused on the management of chronic diseases in primary care (eg, type 2 diabetes, hypertension, cerebrovascular events, and knee osteoarthritis) to improve patient outcomes through a range of services, namely, counseling, education, advice, engagement, monitoring, and prescribing medications. [21][22][23][24]28,31,35 Smoking cessation studies (n = 3, 15%) focused on education, behavioral counseling, one-on-one ongoing support, nicotine dependence, assessment of the willingness to quit based on the subject's "stage of change," and tailored advice on cessation and nicotine replacement therapy.…”

“…[16][17][18][19][20][21]24,28,34,35 A private healthcare system perspective was taken by 2 studies (n = 2). 25,27 Both a public healthcare system and societal perspective were adopted by 2 studies (n = 2). 22,31 A societal or third-party payer perspective was taken by 1 study (n = 1).…”

“…Studies from the United Kingdom used the following thresholds £20 000/QALY, 16,17 £20 000 to £30 000/QALY, 19 and £25 000 to £35 000/QALY. 18 The thresholds used by studies from the United States were $50 000/QALY, 25 $137/QALD, 26 $50 000 to $200 000/ QALY 27 ; Canada, $50 000/QALY 21 ; and Spain, V30 000 to V45 000/ QALY 30 and V30 000/QALY. 31 In addition, thresholds from The Netherlands, V20 000 to V50 000/QALY 29 ; Belgium, V0 per QALY 28 ; France, V40 000/QALY 33 ; and Italy, V30 000/QALY, were also reported.…”