Bereza Basil G, Coyle Doug, So Derek Y, Kadziola Zbigniew, Wells George, Grootendorst Paul, Papadimitropoulos Emmanuel A
University of Toronto Leslie Dan Faculty of Pharmacy, Toronto, ON, Canada.
University of Ottawa School of Epidemiology and Public Health, Toronto, ON, Canada.
Clinicoecon Outcomes Res. 2020 Mar 19;12:167-175. doi: 10.2147/CEOR.S234298. eCollection 2020.
Pharmacogenetic (PGx) testing identifies pharmacotherapeutic risks to permit personalized therapy. Identifying the genetic profile of patients with acute coronary syndrome (ACS) who are considered for therapy with clopidogrel (P2Y receptor blockers) and acetylsalicylic acid (ASA) contributes to the treatment paradigm. Patient preferences would inform a collaborative framework and by extension inform healthcare policy formulation.
To quantify stated preferences (willingness to pay) for attributes of a novel point-of-care PGx () test using a discrete choice experiment (DCE) from the general public in Ontario, Canada, and to identify starting point bias of the cost attribute.
A web survey was created and included a questionnaire, decision board, and a DCE. DCE choice sets include the following attributes (levels): sample collection (blood, finger prick, and cheek swab), turnaround time for results (1 hr, 3 days, and 1 week), and cost in additional insurance premiums. The presence of starting point bias (cost attribute levels of $0, $1, $5 or $0, $2, $10) in the estimation of willingness to pay (WTP) was tested.
Estimates for turnaround time and cost attributes were statistically significant. Coefficients related to the starting point bias were also significant. Approximately 67% of survey participants chose the PGx test compared to status quo treatment options. WTP for a 1 hr turnaround time compared to a 1-week turnaround time was $10.77 (95% CI 9.58 -12.25).
This translational study shows preference for a point of care PGx test.
药物遗传学（PGx）检测可识别药物治疗风险，以实现个性化治疗。确定拟接受氯吡格雷（P2Y受体阻滞剂）和阿司匹林（ASA）治疗的急性冠状动脉综合征（ACS）患者的基因谱，有助于治疗模式的制定。患者偏好将为协作框架提供信息，进而为医疗保健政策的制定提供信息。
使用离散选择实验（DCE），对加拿大安大略省公众对新型即时PGx检测属性的既定偏好（支付意愿）进行量化，并确定成本属性的起点偏差。
创建了一项网络调查，包括一份问卷、决策板和一个DCE。DCE选择集包括以下属性（水平）：样本采集（血液、手指采血和口腔拭子）、结果周转时间（1小时、3天和1周）以及额外保险费中的成本。测试了在支付意愿（WTP）估计中起点偏差（成本属性水平为0美元、1美元、5美元或0美元、2美元、10美元）的存在情况。
周转时间和成本属性的估计具有统计学意义。与起点偏差相关的系数也具有统计学意义。与现状治疗方案相比，约67%的调查参与者选择了PGx检测。与1周转时间相比，1小时周转时间的WTP为10.77美元（95%CI 9.58 - 12.25）。
这项转化研究表明对即时PGx检测存在偏好。
