Pharmacoeconomic evaluation of warfarin pharmacogenomics.

INTRODUCTION

the merit of applying pharmacogenomics in the induction phase of warfarin therapy for personalized dosing is controversial and highly dependent on its cost-effectiveness.

AREAS COVERED

published studies on pharmacoeconomics of warfarin pharmacogenomic application are reviewed. A literature search was done using Medline and Embase covering the period 2000 - 2010. Decision tree and Markov modeling were the most frequently used methods in the reviewed reports. Studies incorporating clinical efficacy data of genotype-guided dosing algorithm had shown that warfarin pharmacogenomics would improve quality-adjusted life-years (QALYs) gained. Nevertheless, it was unlikely to be cost-effective for general patients. Influential factors to improve the cost-effectiveness included low genotyping cost, high effectiveness in improving anticoagulation control/event rate, and applying warfarin pharmacogenomics to patients with high bleeding risk or at practice sites with suboptimal management of anticoagulation control.

EXPERT OPINION

warfarin pharmacogenomics would improve QALYs and could possibly be cost-effective in selected patient groups or practice sites.