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Review
. 2017 Oct;17(5):395-402.
doi: 10.1038/tpj.2017.21. Epub 2017 Jun 13.

Cost-effectiveness of pharmacogenetic-guided treatment: are we there yet?

M Verbelen  1 , M E Weale  2 , C M Lewis  1   2
Affiliations
Review

Cost-effectiveness of pharmacogenetic-guided treatment: are we there yet?

M Verbelen et al. Pharmacogenomics J. 2017 Oct.

Abstract

Pharmacogenetics (PGx) has the potential to personalize pharmaceutical treatments. Many relevant gene-drug associations have been discovered, but PGx-guided treatment needs to be cost-effective as well as clinically beneficial to be incorporated into standard health-care. We reviewed economic evaluations for PGx associations listed in the US Food and Drug Administration (FDA) Table of Pharmacogenomic Biomarkers in Drug Labeling. We determined the proportion of evaluations that found PGx-guided treatment to be cost-effective or dominant over the alternative strategies, and estimated the impact on this proportion of removing the cost of genetic testing. Of the 137 PGx associations in the FDA table, 44 economic evaluations, relating to 10 drugs, were identified. Of these evaluations, 57% drew conclusions in favour of PGx testing, of which 30% were cost-effective and 27% were dominant (cost-saving). If genetic information was freely available, 75% of economic evaluations would support PGx-guided treatment, of which 25% would be cost-effective and 50% would be dominant. Thus, PGx-guided treatment can be a cost-effective and even a cost-saving strategy. Having genetic information readily available in the clinical health record is a realistic future prospect, and would make more genetic tests economically worthwhile.

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Conflict of interest statement

MV is funded by a studentship from the Medical Research Council and Eli Lilly and Company Ltd. MEW is a part-time employee of Genomics plc. CML declares no conflict of interest.

Figures

Figure 1
Figure 1
Cost-effectiveness plane of pharmaco-economic studies. PGx, pharmacogenetics-guided treatment; ST, standard treatment.
Figure 2
Figure 2
Number of drugs and publications included in literature review.
Figure 3
Figure 3
Conclusions of reviewed economic evaluations regarding cost-effectiveness of PGx testing strategy (a) overall and (b) by drug, and estimated conclusions in scenario of no extra cost for genetic information (c) overall and (d) by drug. PGx, pharmacogenetics-guided treatment.
Figure 4
Figure 4
Cost of pharmacogenomics (PGx) test as reported in the reviewed economic evaluations over time, with fitted regression since 2009 (dotted line).
See this image and copyright information in PMC

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