Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Dec;8(6):391-9.
doi: 10.1038/sj.tpj.6500492. Epub 2008 Mar 18.

Cost-effectiveness of pharmacogenetic testing to tailor smoking-cessation treatment

D F Heitjan  1 , D A Asch, Riju Ray, Margaret Rukstalis, Freda Patterson, C Lerman
Affiliations

Cost-effectiveness of pharmacogenetic testing to tailor smoking-cessation treatment

D F Heitjan et al. Pharmacogenomics J. 2008 Dec.

Abstract

We evaluated the cost-effectiveness of a range of smoking cessation drug treatments, including varenicline, transdermal nicotine (TN), bupropion and the use of a genetic test to choose between TN and bupropion. We performed Monte Carlo simulation with sensitivity analysis, informing analyses with published estimates of model parameters and current prices for genetic testing and smoking-cessation therapy. The primary outcomes were discounted life-years (LY) and lifetime tobacco-cessation treatment costs. In the base case, varenicline treatment was optimal with an ICER, compared to bupropion, of $2985/LY saved. In sensitivity analyses, varenicline was in all cases (and bupropion in most cases) admissible; only under favorable assumptions was the genetically tailored approach competitive. Our data suggest that an untailored approach of treatment with either bupropion or varenicline is a cost-effective form of tobacco dependence treatment, but a tailored approach for selecting between TN and bupropion can be cost-effective under plausible assumptions.

PubMed Disclaimer

Conflict of interest statement

Duality of interest and financial disclosures

Dr Lerman has served as a consultant to Glaxo Smith-Kline, who provided bupropion and placebo for the studies described. She has also served as a consultant for Pfizer and has received funding for a project unrelated to the data presented in this paper. The other authors have no conflicts of interest to disclose.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Munafò MR, Shields AE, Berrettini WH, Patterson F, Lerman C. Pharmacogenetics and nicotine addiction treatment. Pharmacogenomics. 2005;6:211–223. - PubMed
    1. Kirchheiner J, Nickchen K, Bauer M, Wong ML, Licinio J, Roots I, et al. Pharmacogenetics of antidepressants and antipsychotics: the contribution of allelic variations to the phenotype of drug response. Mol Psychiatry. 2004;9:442–473. - PubMed
    1. Schafer M, Rujescu D, Giegling I, Guntermann A, Erfurth A, Bondy B, et al. Association of short-term response to haloperidol treatment with a polymorphism in the dopamine D(2) receptor gene. Am J Psychiatry. 2001;158:802–804. - PubMed
    1. Peters EJ, Slager SL, McGrath PJ, Knowles JA, Hamilton SP. Investigation of serotonin-related genes in antidepressant response. Mol Psychiatry. 2004;9:879–889. - PubMed
    1. Polanczyk G, Zeni C, Genro JP, Guimaraes AP, Roman T, Hutz MH, et al. Association of the adrenergic alpha2A receptor gene with methylphenidate improvement of inattentive symptoms in children and adolescents with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 2007;64:218–224. - PubMed

Publication types