Abstract
AIM: To investigate the cost-effectiveness of a pharmacogenetic dosing algorithm versus a clinical dosing algorithm for coumarin anticoagulants in The Netherlands.
MATERIALS & METHODS: A decision-analytic Markov model was used to analyze the cost-effectiveness of pharmacogenetic dosing of phenprocoumon and acenocoumarol versus clinical dosing.
RESULTS: Pharmacogenetic dosing increased costs by €33 and quality-adjusted life-years (QALYs) by 0.001. The incremental cost-effectiveness ratios were €28,349 and €24,427 per QALY gained for phenprocoumon and acenocoumarol, respectively. At a willingness-to-pay threshold of €20,000 per QALY, the pharmacogenetic dosing algorithm was not likely to be cost effective compared with the clinical dosing algorithm.
CONCLUSION: Pharmacogenetic dosing improves health only slightly when compared with clinical dosing. However, availability of low-cost genotyping would make it a cost-effective option.
| Original language | English |
|---|---|
| Pages (from-to) | 101-14 |
| Number of pages | 14 |
| Journal | Pharmacogenomics |
| Volume | 16 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Jan 2015 |
Keywords
- Acenocoumarol
- Aged
- Aged, 80 and over
- Algorithms
- Anticoagulants
- Cost-Benefit Analysis
- Coumarins
- Drug Costs
- Humans
- Markov Chains
- Middle Aged
- Netherlands
- Pharmacogenetics
- Phenprocoumon
- Quality-Adjusted Life Years
- Thromboembolism