Cost-effectiveness of genotype-guided warfarin therapy for anticoagulation in elderly patients with atrial fibrillation

Leey, Julio; McCabe, Steve; Koch, Jennifer; Miles, Toni P.

doi:10.1016/j.amjopharm.2009.07.002

Cited by 39 publications

(27 citation statements)

References 17 publications

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“…Of these 15 articles, four studies concerned CYP2C9 and VKORC1 alleles and warfarin and thromboembolic diseases/non valvular atrial fibrillation [14][15][16][17] 10.145). Two studies con cerned UGT1A1*28, irinotecan and metastatic colorectal cancer [21,22], (see SupplemenTary Table 5; www.futuremedicine.com.doi.suppl.10.2217/ pgs.10.145).…”

Section: Resultsmentioning

confidence: 99%

“…Across these studies the identifier considered was more heterogeneous: all warfarin studies [14,15,17] except Eckman et al [16] used CYP2C9 and VKORC1 haplotype groups without specifying which patients with combinations of genetic variants received the pharmacogenomic dosage. Eckman et al have used the same source study but with clearly defined CYP2C9*2 and/or *3 genotypes, and VKORC1 lowdose haplotypes combinations versus normal dose combinations.…”

Section: Comments On the Studiesmentioning

confidence: 99%

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Systematic Review of Pharmacoeconomic Studies of Pharmacogenomic Tests

Beaulieu¹,

Denus

Lachaine

2010

Pharmacogenomics

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There is currently a lack of consensus on the components that should be included in the pharmacoeconomic evaluation of pharmacogenomic tests. We conducted a systematic review focusing on pharmacogenomic tests to identify and comment on key parameters. The articles selected as economic analyses were classified using a framework including components related to testing, model, health outcomes, costs and incremental cost-effectiveness ratio. We found 15 studies that met our inclusion and exclusion criteria. A high degree of heterogeneity between evaluations was observed even within studies evaluating the same pharmacogenomic test. Components specific to pharmacogenomic tests were identified as marker prevalence, population ethnicity, pharmacogenomic treatment effect and cost of genomic data collection and analysis. In order to fully assess all aspects of pharmacogenomic testing, future pharmacoeconomic assessments should include every specific component that has an impact on the incremental cost-effectiveness ratio.

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Section: Resultsmentioning

confidence: 99%

Section: Comments On the Studiesmentioning

confidence: 99%

Systematic Review of Pharmacoeconomic Studies of Pharmacogenomic Tests

Beaulieu¹,

Denus

Lachaine

2010

Pharmacogenomics

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“…For example, genotype-guided warfarin therapy for anticoagulation in elderly patients with AF was reported to be potentially cost-effective, and its benefits were closely related to efficacy in preventing bleeding events [120] . However, in general, the clinical usefulness of genetics testing was low, such as the activated protein C resistance/factor V Leiden mutation test [121] .…”

Section: Potential Clinical Application Of Genetics Of Strokementioning

confidence: 99%

Genetics of stroke

Guo

Liu

2010

Acta Pharmacol Sin

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Stroke is the second most common cause of death and the most common cause of disability in developed countries. Stroke is a multifactorial disease caused by a combination of environmental and genetic factors. Numerous epidemiologic studies have documented a significant genetic component in the occurrence of strokes. Genes encoding products involved in lipid metabolism, thrombosis, and inflammation are believed to be potential genetic factors for stroke. Although a large group of candidate genes have been studied, most of the epidemiological results are conflicting. Studies of stroke as a monogenic disease have made huge progress, and animal models serve as an indispensable tool to dissect the complex genetics of stroke. In the present review, we provide insight into the role of in vivo stroke models for the study of stroke genetics.

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“…This model found only a small improvement in Quality Adjusted Life Years (QALY) (0.003) with an absolute increase in costs of US$162. An earlier decision analysis found that PGx testing would be cost-effective in elderly atrial fibrillation patients only if it significantly reduced bleeding events [53]. A more recent paper by Patrick and colleagues used a baseline cost of PGx test at about approximately US$500 (2009 dollars) to perform a similar cost effectiveness analysis on atrial fibrillation patients receiving warfarin [54].…”

Section: Summary Of Findingsmentioning

confidence: 98%

Clinical applications of pharmacogenomics guided warfarin dosing

et al. 2011

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Several studies have shown that pharmacogenomic testing for warfarin dosing is more accurate that other dosing schemes. Pharmacogenomic testing improves time to a therapeutic international normalized ratio while requiring fewer dosing adjustments. Patients who require higher or lower than usual doses seem to benefit the most. The cost-effectiveness of pharmacogenomic testing as well as preventing of outcomes such as bleeding or thrombosis are not yet elucidated. Pharmacists, especially those in a community setting can play a role in this new technology by educating prescribers and patients concerning pharmacogenomic testing, and by developing and using dosing protocols that incorporate its use.

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Cost-effectiveness of genotype-guided warfarin therapy for anticoagulation in elderly patients with atrial fibrillation

Cited by 39 publications

References 17 publications

Systematic Review of Pharmacoeconomic Studies of Pharmacogenomic Tests

Systematic Review of Pharmacoeconomic Studies of Pharmacogenomic Tests

Genetics of stroke

Clinical applications of pharmacogenomics guided warfarin dosing

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