Cost Effectiveness of Pharmacogenomics
- 1 November 2010
- journal article
- review article
- Published by Springer Science and Business Media LLC in PharmacoEconomics
- Vol. 28 (11), 1001-1013
- https://doi.org/10.2165/11537410-000000000-00000
Abstract
The use of pharmacogenetic testing in clinical practice is limited thus far. A potential barrier to the widespread implementation of pharmacogenetic testing is the lack of evidence on whether testing provides good value for money. The objective of this review was to provide a systematic and critical review of economic evaluations of pharmacogenetic testing. A literature search using publically available databases was performed for articles published up to October 2009. To be included, studies had to meet the definition of being a pharmacogenomic study (defined as use of information on human genetic variation to target drug therapy) and an economic evaluation (defined as an evaluation of both costs and clinical outcomes). Articles that met these criteria were subsequently reviewed and graded using the Quality of Health Economic Studies (QHES) instrument. Lastly, the evidence for biomarker validity and utility were qualitatively assessed using expert opinion. A total of 34 articles were identified using our defined criteria. The most common disease category was thromboembolic-related diseases (26%), while the most common biomarkers were thiopurine methyltransferase and cytochrome P450 2C9 (18% each). Almost all studies were published after 2004 (91%). Two types of studies were identified: cost-effectiveness studies and cost-utility studies, with roughly half of the overall studies being cost-utility studies (53%) and a majority of these published within the last 3 years. The average quality score was 77 (range 29–99). Of the biomarkers reviewed, it was estimated that most had demonstrated clinical validity, but only two had demonstrated clinical utility. Despite a recent increase in the number of economic evaluations of pharmacogenetic applications, further studies examining the clinical validity and utility of these biomarkers are needed to support cost-effectiveness assessments.Keywords
This publication has 84 references indexed in Scilit:
- Genetic and environmental factors determining clinical outcomes and cost of warfarin therapy: a prospective studyPharmacogenetics and Genomics, 2009
- Personalized Medicine and Inhibition ofEGFRSignaling in Lung CancerNew England Journal of Medicine, 2009
- Cost effectiveness of pharmacogenetic testing for uridine diphosphate glucuronosyltransferase 1A1 before irinotecan administration for metastatic colorectal cancerCancer, 2009
- When is Pharmacogenetic Testing for Antidepressant Response Ready for the Clinic? A Cost-effectiveness Analysis Based on Data from the STAR*D StudyNeuropsychopharmacology, 2009
- Genetic Testing Before Anticoagulation? A Systematic Review of Pharmacogenetic Dosing of WarfarinJournal of General Internal Medicine, 2009
- Estimation of the Warfarin Dose with Clinical and Pharmacogenetic DataNew England Journal of Medicine, 2009
- Recommendations from the EGAPP Working Group: can UGT1A1 genotyping reduce morbidity and mortality in patients with metastatic colorectal cancer treated with irinotecan?Genetics in Medicine, 2009
- Association of the DRD2 gene Taq1A polymorphism and smoking behavior: A meta-analysis and new dataNicotine & Tobacco Research, 2009
- A cost-effectiveness analysis of genetic testing of the DRD2 Taq1A polymorphism to aid treatment choice for smoking cessationNicotine & Tobacco Research, 2008
- Impact of a 21‐gene RT‐PCR assay on treatment decisions in early‐stage breast cancerCancer, 2007