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Implementation of pharmacogenomic clinical decision support for health systems: a cost-utility analysis.
- Source :
-
The pharmacogenomics journal [Pharmacogenomics J] 2022 May; Vol. 22 (3), pp. 188-197. Date of Electronic Publication: 2022 Apr 01. - Publication Year :
- 2022
-
Abstract
- We constructed a cost-effectiveness model to assess the clinical and economic value of a CDS alert program that provides pharmacogenomic (PGx) testing results, compared to no alert program in acute coronary syndrome (ACS) and atrial fibrillation (AF), from a health system perspective. We defaulted that 20% of 500,000 health-system members between the ages of 55 and 65 received PGx testing for CYP2C19 (ACS-clopidogrel) and CYP2C9, CYP4F2 and VKORC1 (AF-warfarin) annually. Clinical events, costs, and quality-adjusted life years (QALYs) were calculated over 20 years with an annual discount rate of 3%. In total, 3169 alerts would be fired. The CDS alert program would help avoid 16 major clinical events and 6 deaths for ACS; and 2 clinical events and 0.9 deaths for AF. The incremental cost-effectiveness ratio was $39,477/QALY. A PGx-CDS alert program was cost-effective, under a willingness-to-pay threshold of $100,000/QALY gained, compared to no alert program.<br /> (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)
- Subjects :
- Aged
Anticoagulants adverse effects
Clopidogrel
Cost-Benefit Analysis
Humans
Markov Chains
Middle Aged
Pharmacogenetics
Quality-Adjusted Life Years
Vitamin K Epoxide Reductases genetics
Warfarin
Acute Coronary Syndrome drug therapy
Acute Coronary Syndrome genetics
Atrial Fibrillation drug therapy
Atrial Fibrillation genetics
Decision Support Systems, Clinical
Subjects
Details
- Language :
- English
- ISSN :
- 1473-1150
- Volume :
- 22
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The pharmacogenomics journal
- Publication Type :
- Academic Journal
- Accession number :
- 35365779
- Full Text :
- https://doi.org/10.1038/s41397-022-00275-7