荷兰香豆素类抗凝剂药物基因组学给药算法的经济学评估。
Economic evaluation of a pharmacogenetic dosing algorithm for coumarin anticoagulants in The Netherlands.
作者信息
Verhoef Talitha I, Redekop William K, de Boer Anthonius, Maitland-van der Zee Anke Hilse
机构信息
Utrecht Institute of Pharmaceutical Sciences, Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.
出版信息
Pharmacogenomics. 2015 Jan;16(2):101-14. doi: 10.2217/pgs.14.149.
AIM
To investigate the cost-effectiveness of a pharmacogenetic dosing algorithm versus a clinical dosing algorithm for coumarin anticoagulants in The Netherlands.
MATERIALS & METHODS: A decision-analytic Markov model was used to analyze the cost-effectiveness of pharmacogenetic dosing of phenprocoumon and acenocoumarol versus clinical dosing.
RESULTS
Pharmacogenetic dosing increased costs by €33 and quality-adjusted life-years (QALYs) by 0.001. The incremental cost-effectiveness ratios were €28,349 and €24,427 per QALY gained for phenprocoumon and acenocoumarol, respectively. At a willingness-to-pay threshold of €20,000 per QALY, the pharmacogenetic dosing algorithm was not likely to be cost effective compared with the clinical dosing algorithm.
CONCLUSION
Pharmacogenetic dosing improves health only slightly when compared with clinical dosing. However, availability of low-cost genotyping would make it a cost-effective option.
目的
研究荷兰香豆素类抗凝剂的药物遗传学给药算法与临床给药算法的成本效益。
材料与方法
采用决策分析马尔可夫模型分析苯丙香豆素和醋硝香豆素的药物遗传学给药与临床给药的成本效益。
结果
药物遗传学给药使成本增加33欧元，质量调整生命年（QALY）增加0.001。苯丙香豆素和醋硝香豆素每获得一个QALY的增量成本效益比分别为28,349欧元和24,427欧元。在每QALY支付意愿阈值为20,000欧元时，与临床给药算法相比，药物遗传学给药算法不太可能具有成本效益。
结论
与临床给药相比，药物遗传学给药对健康的改善仅略有提升。然而，低成本基因分型的可用性将使其成为具有成本效益的选择。
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