Economic evaluation of a pharmacogenetic dosing algorithm for coumarin anticoagulants in The Netherlands
Publication date
2015-01
Authors
Verhoef, T.I.
Redekop, William K
de Boer, A.
Maitland-van der Zee, Anke Hilse
EU-PACT Group
Editors
Advisors
Supervisors
Document Type
Article
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taverne
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.
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, Taverne
Citation
Verhoef, T I, Redekop, W K, de Boer, A, Maitland-van der Zee, A H & EU-PACT Group 2015, 'Economic evaluation of a pharmacogenetic dosing algorithm for coumarin anticoagulants in The Netherlands', Pharmacogenomics, vol. 16, no. 2, pp. 101-14. https://doi.org/10.2217/pgs.14.149