Cost-effectiveness of pharmacogenetic-guided dosing of warfarin in the United Kingdom and Sweden

Verhoef, TI, Redekop, WK, Langenskiold, S, Kamali, F, Wadelius, M, Burnside, G ORCID: 0000-0001-7398-1346, Maitland-van der Zee, A-H, Hughes, DA ORCID: 0000-0001-8247-7459 and Pirmohamed, M ORCID: 0000-0002-7534-7266 (2016) Cost-effectiveness of pharmacogenetic-guided dosing of warfarin in the United Kingdom and Sweden. PHARMACOGENOMICS JOURNAL, 16 (5). pp. 478-484.

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Abstract

We aimed to assess the cost-effectiveness of pharmacogenetic-guided dosing of warfarin in patients with atrial fibrillation (AF) in the United Kingdom and Sweden. Data from EU-PACT, a randomized controlled trial in newly diagnosed AF patients, were used to model the incremental costs per quality-adjusted life-year (QALY) gained by pharmacogenetic-guided warfarin dosing versus standard treatment over a lifetime horizon. Incremental lifetime costs were £26 and 382 Swedish kronor (SEK) and incremental QALYs were 0.0039 and 0.0015 in the United Kingdom and Sweden, respectively. The corresponding incremental cost-effectiveness ratios (ICERs) were £6 702 and 253 848 SEK per QALY gained. The ICER was below the willingness-to-pay threshold of £20 000 per QALY gained in 93% of the simulations in the United Kingdom and below 500 000 SEK in 67% of the simulations in Sweden. Our data suggest that pharmacogenetic-guided dosing of warfarin is a cost-effective strategy to improve outcomes of patients with AF treated with warfarin in the United Kingdom and in Sweden.

Item Type:	Article
Uncontrolled Keywords:	Humans, Atrial Fibrillation, Warfarin, Anticoagulants, Drug Monitoring, International Normalized Ratio, Treatment Outcome, Models, Economic, Markov Chains, Predictive Value of Tests, Pharmacogenetics, Quality-Adjusted Life Years, Patient Selection, Quality of Life, Aged, Cost-Benefit Analysis, Drug Costs, Sweden, Female, Male, Randomized Controlled Trials as Topic, Drug Dosage Calculations, Vitamin K Epoxide Reductases, Cytochrome P-450 CYP2C9, Precision Medicine, United Kingdom, Pharmacogenomic Variants, Pharmacogenomic Testing
Depositing User:	Symplectic Admin
Date Deposited:	05 Jul 2016 09:36
Last Modified:	19 Jan 2023 07:34
DOI:	10.1038/tpj.2016.41
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3002090