A Systematic Review of Economic Evaluations of Pharmacogenetic Testing for Prevention of Adverse Drug Reactions

Background Pharmacogenetics offers the potential to improve health outcomes by identifying individuals who are at greater risk of harm from certain medicines. Routine adoption of pharmacogenetic tests requires evidence of their cost effectiveness. Objective The present review aims to systematically...

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Bibliographic Details
Published in:PharmacoEconomics Vol. 34; no. 8; pp. 771 - 793
Main Authors: Plumpton, Catrin O., Roberts, Daniel, Pirmohamed, Munir, Hughes, Dyfrig A.
Format: Journal Article
Language:English
Published: Cham Springer International Publishing 01.08.2016
Springer
Springer Nature B.V
Subjects:
Adverse and side effects
Cost-Benefit Analysis
Drug-Related Side Effects and Adverse Reactions - economics
Drug-Related Side Effects and Adverse Reactions - epidemiology
Drug-Related Side Effects and Adverse Reactions - prevention & control
Drugs
Economic aspects
Evaluation
Genotype
Health Administration
Health Economics
Humans
Incidence
Medicine
Medicine & Public Health
Methods
Pharmacoeconomics and Health Outcomes
Pharmacogenetics
Pharmacogenetics - economics
Pharmacogenetics - methods
Pharmacogenomic Testing - economics
Pharmacogenomic Testing - methods
Public Health
Quality of Life Research
Side effects
Systematic Review
United Kingdom
Prasugrel
Clopidogrel
Economic Evaluation
Carbamazepine
Abacavir
ISSN:1170-7690, 1179-2027
Online Access:Get full text
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Description
Summary:Background Pharmacogenetics offers the potential to improve health outcomes by identifying individuals who are at greater risk of harm from certain medicines. Routine adoption of pharmacogenetic tests requires evidence of their cost effectiveness. Objective The present review aims to systematically review published economic evaluations of pharmacogenetic tests that aim to prevent or reduce the incidence of ADRs. Methods We conducted a systematic literature review of economic evaluations of pharmacogenetic tests aimed to reduce the incidence of adverse drug reactions. Literature was searched using Embase, MEDLINE and the NHS Economic Evaluation Database with search terms relating to pharmacogenetic testing, adverse drug reactions, economic evaluations and pharmaceuticals. Titles were screened independently by two reviewers. Articles deemed to meet the inclusion criteria were screened independently on abstract, and full texts reviewed. Results We identified 852 articles, of which 47 met the inclusion criteria. There was evidence supporting the cost effectiveness of testing for HLA - B*57:01 (prior to abacavir), HLA - B*15:02 and HLA - A*31:01 (prior to carbamazepine), HLA - B*58:01 (prior to allopurinol) and CYP2C19 (prior to clopidogrel treatment). Economic evidence was inconclusive with respect to TPMT (prior to 6-mercaptoputine, azathioprine and cisplatin therapy), CYP2C9 and VKORC1 (to inform genotype-guided dosing of coumarin derivatives), MTHFR (prior to methotrexate treatment) and factor V Leiden testing (prior to oral contraception). Testing for A1555G is not cost effective before prescribing aminoglycosides. Conclusions Our systematic review identified robust evidence of the cost effectiveness of genotyping prior to treatment with a number of common drugs. However, further analyses and (or) availability of robust clinical evidence is necessary to make recommendations for others.
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ISSN:1170-7690
1179-2027
DOI:10.1007/s40273-016-0397-9