Economic burden of adverse drug reactions and potential for pharmacogenomic testing in Singaporean adults
| Autor: | Michael D. Winther, Cynthia Sung, Sze Ling Chan, Alexandre Chan, Hong Yen Ng, Liam R. Brunham, Hwee Lin Wee |
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| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Drug-Related Side Effects and Adverse Reactions Total cost Pharmacogenomic Testing 030226 pharmacology & pharmacy 03 medical and health sciences 0302 clinical medicine Cost of Illness Genetics Humans Medicine health care economics and organizations Health policy Aged Pharmacology Singapore business.industry Incidence Incidence (epidemiology) Case-control study Warfarin Health Care Costs Middle Aged Clopidogrel Hospitalization 030104 developmental biology Case-Control Studies Emergency medicine Molecular Medicine Female business Pharmacogenetics medicine.drug |
| Zdroj: | The Pharmacogenomics Journal. 19:401-410 |
| ISSN: | 1473-1150 1470-269X |
| DOI: | 10.1038/s41397-018-0053-1 |
| Popis: | Adverse drug reactions (ADRs) contribute to hospitalization but data on its economic burden is scant. Pre-emptive pharmacogenetic (PGx) testing can potentially reduce ADRs and its associated costs. The objectives of this study were to quantify the economic burden of ADRs and to estimate the breakeven cost of pre-emptive PGx testing in Singapore. We collected itemized costs for 1000 random non-elective hospitalizations of adults admitted to a tertiary-care general hospital in Singapore. The presence of ADRs at admission and their clinical characteristics were reported previously. The economic burden of ADRs was assessed from two perspectives: (1) Total cost and (2) incremental costs. The breakeven cost of PGx testing was estimated by dividing avoidable hospitalization costs for ADRs due to selected drugs by the number of patients taking those drugs. The total cost of 81 admissions caused by ADRs was US$570,404. Costs were significantly higher for bleeding/elevated international normalized ratio (US$9906 vs. US$2251, p = 6.58 × 10-3) compared to other ADRs, and for drugs acting on the blood coagulation system (US$9884 vs. US$2229, p = 4.41 × 10-3) compared to other drug classes. There were higher incremental laboratory costs due to ADRs causing or being present at admission. The estimated breakeven cost of a pre-emptive PGx test for patients taking warfarin, clopidogrel, chemotherapeutic and neuropsychiatric drugs was US$114 per patient. These results suggest that future studies designed to directly measure the clinical and cost impact of a pre-emptive genotyping program will help inform clinical practice and health policy decisions. |
| Databáze: | OpenAIRE |
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