The Golden Helix Foundation, London, UK.
Department of Pharmacy, Laboratory of Pharmacogenomics and Individualized Therapy, University of Patras, School of Health Sciences, Patras, Greece.
Pharmacogenomics J. 2024 Mar 18;24(2):10. doi: 10.1038/s41397-024-00330-5.
Chronic kidney disease (CKD) is a global health issue. Kidney failure patients may undergo a kidney transplantation (KTX) and prescribed an immunosuppressant medication i.e., tacrolimus. Tacrolimus' efficacy and toxicity varies among patients. This study investigates the cost-utility of pharmacogenomics (PGx) guided tacrolimus treatment compared to the conventional approach in Austrian patients undergone KTX, participating in the PREPARE UPGx study. Treatment's effectiveness was determined by mean survival, and utility values were based on a Visual Analog Scale score. Incremental Cost-Effectiveness Ratio was also calculated. PGx-guided treatment arm was found to be cost-effective, resulting in reduced cost (3902 euros less), 6% less hospitalization days and lower risk of adverse drug events compared to the control arm. The PGx-guided arm showed a mean 0.900 QALYs (95% CI: 0.862-0.936) versus 0.851 QALYs (95% CI: 0.814-0.885) in the other arm. In conclusion, PGx-guided tacrolimus treatment represents a cost-saving option in the Austrian healthcare setting.
慢性肾脏病（CKD）是一个全球性的健康问题。肾衰竭患者可能会接受肾移植（KTX）并开处免疫抑制剂药物，如他克莫司。他克莫司在不同患者中的疗效和毒性有所不同。本研究调查了在奥地利接受 KTX 并参与 PREPARE UPGx 研究的患者中，基于药物基因组学（PGx）指导的他克莫司治疗相对于常规治疗的成本效益。治疗的有效性通过平均生存来确定，而效用值则基于视觉模拟评分。还计算了增量成本效益比。与对照组相比，PGx 指导治疗组具有成本效益，因为它降低了成本（少 3902 欧元），住院天数减少了 6%，并且发生药物不良事件的风险更低。PGx 指导组的平均 QALYs 为 0.900（95%CI：0.862-0.936），而对照组为 0.851（95%CI：0.814-0.885）。总之，在奥地利的医疗保健环境中，PGx 指导的他克莫司治疗是一种节省成本的选择。
