Pharmacoeconomic evaluations of pharmacogenetic and genomic screening programmes: a systematic review on content and adherence to guidelines

Autor: Gerjan Navis, Stefan Vegter, Cornelis Boersma, Maarten J. Postma, Bob Wilffert, Mark H. Rozenbaum
Rok vydání: 2008
Předmět:
hypotension
drug safety
Cost effectiveness
Cost-Benefit Analysis
gefitinib
thiopurine methyltransferase
high risk patient
10 methylenetetrahydrofolate reductase (FADH2)
Health administration
hydroxymethylglutaryl coenzyme A reductase inhibitor
systematic review
Cytochrome P-450 Enzyme System
genetic variability
genetic polymorphism
cytochrome P450 2C9
Thiopurine methyltransferase
biology
clozapine
tamoxifen
hypercholesterolemia
Genetic Screening
non insulin dependent diabetes mellitus
Health Policy
evidence based practice
Cost-effectiveness analysis
highly active antiretroviral therapy
health care
clinical practice
priority journal
gene insertion
RNA 12S
medicine.medical_specialty
Evidence-based practice
HLA antigen
Genotype
phenotype
prevalence
MEDLINE
dipeptidyl carboxypeptidase
review
Guidelines as Topic
reduced nicotinamide adenine dinucleotide (phosphate) dehydrogenase (quinone)
Sensitivity and Specificity
alpha adducin
drug metabolizing enzyme
Human immunodeficiency virus infection
medicine
pharmacodynamics
Humans
human
Economics
Pharmaceutical
Genetic Testing
Intensive care medicine
cytochrome P450 2D6
cost control
Pharmacology
pharmacogenomics
standardization
business.industry
acenocoumarol
gene deletion
dihydropyrimidine dehydrogenase
cost effectiveness analysis
practice guideline
abacavir
Public Health
Environmental and Occupational Health
hearing impairment
economic aspect
warfarin
drug efficacy
schizophrenia
phenprocoumon
Pharmacogenetics
Pharmacogenomics
Gram negative infection
biology.protein
aminoglycoside
cytochrome P450 2C19
business
drug hypersensitivity
Zdroj: PharmacoEconomics. 26(7)
ISSN: 1170-7690
Popis: The fields of pharmacogenetics and pharmacogenomics have become important practical tools to progress goals in medical and pharmaceutical research and development. As more screening tests are being developed, with some already used in clinical practice, consideration of cost-effectiveness implications is important. A systematic review was performed on the content of and adherence to pharmacoeconomic guidelines of recent pharmacoeconomic analyses performed in the field of pharmacogenetics and pharmacogenomics. Economic analyses of screening strategies for genetic variations, which were evidence-based and assumed to be associated with drug efficacy or safety, were included in the review. The 20 papers included cover a variety of healthcare issues, including screening tests on several cytochrome P450 (CYP) enzyme genes, thiopurine S-methyltransferase (TMPT) and angiotensin-converting enzyme (ACE) insertion deletion (ACE I/D) polymorphisms. Most economic analyses reported that genetic screening was cost effective and often even clearly dominated existing non-screening strategies. However, we found a lack of standardization regarding aspects such as the perspective of the analysis, factors included in the sensitivity analysis and the applied discount rates. In particular, an important limitation of several studies related to the failure to provide a sufficient evidence-based rationale for an association between genotype and phenotype. Future economic analyses should be conducted utilizing correct methods, with adherence to guidelines and including extensive sensitivity analyses. Most importantly, genetic screening strategies should be based on good evidence-based rationales. For these goals, we provide a list of recommendations for good pharmacoeconomic practice deemed useful in the fields of pharmacogenetics and pharmacogenomics, regardless of country and origin of the economic analysis. © 2008 Adis Data Information BV. All rights reserved.
Databáze: OpenAIRE
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