Cost‐Effectiveness of Panel Tests for Multiple Pharmacogenes Associated With Adverse Drug Reactions: An Evaluation Framework

Plumpton, Catrin O, Pirmohamed, Munir ORCID: 0000-0002-7534-7266 and Hughes, Dyfrig A ORCID: 0000-0001-8247-7459 (2019) Cost‐Effectiveness of Panel Tests for Multiple Pharmacogenes Associated With Adverse Drug Reactions: An Evaluation Framework. Clinical pharmacology and therapeutics, 105 (6). pp. 1429-1438.

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Abstract

The cost-effectiveness of testing for multiple genes implicated in adverse drug reactions requires the simultaneous assessment of all actionable information, including future prescribing decisions based on incidental findings. We developed methodology for determining the value of pharmacogenetic panel tests, illustrated with a multigene panel, including HLA-A*31:01, HLA-B*15:02, HLA-B*57:01, HLA-B*58:01, HLA-B (158T), and HLA-DQB1 (126Q). If the findings for all alleles are acted upon, regardless of their individual cost-effectiveness, the HLA panel resulted in cost savings of £378 (US $491), and a quality-adjusted life year gain of 0.0069. Based on a stratified analysis and compared with no testing, initial use of the panel was cost-effective in patients eligible for abacavir (HLA-B*57:01), carbamazepine (HLA-A*31:01), and clozapine (HLA-B (158T) and HLA-DQB1 (126Q)), but not for carbamazepine (HLA-B*15:02) or allopurinol (HLA-B*58:01). The methods presented allow for the assessment of the cost-effectiveness of multiple-gene panels.

Item Type:	Article
Uncontrolled Keywords:	Humans, Anticonvulsants, Gout Suppressants, HLA-A Antigens, HLA-B Antigens, Cost-Benefit Analysis, Drug-Related Side Effects and Adverse Reactions, Pharmacogenomic Testing
Depositing User:	Symplectic Admin
Date Deposited:	05 Feb 2019 12:00
Last Modified:	19 Jan 2023 01:05
DOI:	10.1002/cpt.1312
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3032288