Joost W Geenen1, Ekaterina V Baranova1, Folkert W Asselbergs2,3,4, Anthonius de Boer1, Rick A Vreman1, Colin Na Palmer5, Anke H Maitland-van der Zee1,6, Anke M Hövels1. 1. Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO Box 80082, 3508 TB Utrecht, The Netherlands. 2. Department of Cardiology, Division Heart & Lungs, UMC Utrecht, 3508 GA Utrecht, The Netherlands. 3. Durrer Center for Cardiovascular Research, Netherlands Heart Institute, 3501 DG Utrecht, The Netherlands. 4. Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, WC1E 6BT London, UK. 5. Population Pharmacogenetics Group, Biomedical Research Centre, University of Dundee, Ninewells Hospital & Medical School, DD2 1GZ Dundee, UK. 6. Department of Respiratory Disease, Academic Medical Center, PO Box 22660,1100 DD, Amsterdam, The Netherlands.
Abstract
AIM: To assess the required characteristics (cost, sensitivity and specificity) of a pharmacogenomic test for being a cost-effective prevention of angiotensin-converting enzyme inhibitors induced angioedema. Furthermore, we assessed the influence of only testing high-risk populations. MATERIALS & METHODS: A decision tree was used. RESULTS: With a willingness-to-pay threshold of €20,000 and €80,000 per quality adjusted life year, a 100% sensitive and specific test may have a maximum cost of €1.30 and €1.95, respectively. When only genotyping high-risk populations, the maximum test price would be €5.03 and €7.55, respectively. CONCLUSION: This theoretical pharmacogenomic test is only cost-effective at high specificity, high sensitivity and a low price. Only testing high-risk populations yields more realistic maximum test prices for cost-effectiveness of the intervention.
AIM: To assess the required characteristics (cost, sensitivity and specificity) of a pharmacogenomic test for being a cost-effective prevention of angiotensin-converting enzyme inhibitors induced angioedema. Furthermore, we assessed the influence of only testing high-risk populations. MATERIALS & METHODS: A decision tree was used. RESULTS: With a willingness-to-pay threshold of €20,000 and €80,000 per quality adjusted life year, a 100% sensitive and specific test may have a maximum cost of €1.30 and €1.95, respectively. When only genotyping high-risk populations, the maximum test price would be €5.03 and €7.55, respectively. CONCLUSION: This theoretical pharmacogenomic test is only cost-effective at high specificity, high sensitivity and a low price. Only testing high-risk populations yields more realistic maximum test prices for cost-effectiveness of the intervention.
Entities:
Keywords:
ACE inhibitor induced angioedema; ACE inhibitors; adverse drug reactions; angioedema; cardiovascular drugs; cost–effectiveness; health technology assessment; pharmacogenomic test
Authors: Rick A Vreman; Joost W Geenen; Anke M Hövels; Wim G Goettsch; Hubert G M Leufkens; Maiwenn J Al Journal: Appl Health Econ Health Policy Date: 2019-12 Impact factor: 2.561
Authors: Ye Zhu; Kristi M Swanson; Ricardo L Rojas; Zhen Wang; Jennifer L St Sauver; Sue L Visscher; Larry J Prokop; Suzette J Bielinski; Liewei Wang; Richard Weinshilboum; Bijan J Borah Journal: Genet Med Date: 2019-10-08 Impact factor: 8.822