Systematic Review Finds Most Pharmacogenomic Tests Are Cost-Effective
This systematic review of 108 cost-effectiveness studies covering 39 drugs with CPIC guidelines found that 71% of evaluations showed pharmacogenomic testing to be cost-effective or cost-saving. Clopidogrel testing had the strongest evidence (22 of 23 studies favourable), followed by HLA testing for abacavir, allopurinol, and carbamazepine. The findings provide laboratory directors and health-system leaders with robust economic justification for implementing preemptive pharmacogenomic testing programmes.
The original study
Cost Effectiveness of Pharmacogenetic Testing for Drugs with Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines: A Systematic Review.
- Authors
- Morris SA, Alsaidi AT, Verbyla A, Cruz A, Macfarlane C, Bauer J, et al.
- Journal
- Clinical pharmacology and therapeutics
- Type
- Systematic Review, Journal Article
- PMID
- 36149409
Original abstract
The objective of this study was to evaluate the evidence on cost-effectiveness of pharmacogenetic (PGx)-guided treatment for drugs with Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. A systematic review was conducted using multiple biomedical literature databases from inception to June 2021. Full articles comparing PGx-guided with nonguided treatment were included for data extraction. Quality of Health Economic Studies (QHES) was used to assess robustness of each study (0-100). Data are reported using descriptive statistics. Of 108 studies evaluating 39 drugs, 77 (71%) showed PGx testing was cost-effective (CE) (N = 48) or cost-saving (CS) (N = 29); 21 (20%) were not CE; 10 (9%) were uncertain. Clopidogrel had the most articles (N = 23), of which 22 demonstrated CE or CS, followed by warfarin (N = 16), of which 7 demonstrated CE or CS. Of 26 studies evaluating human leukocyte antigen (HLA) testing for abacavir (N = 8), allopurinol (N = 10), or carbamazepine/phenytoin (N = 8), 15 demonstrated CE or CS. Nine of 11 antidepressant articles demonstrated CE or CS. The median QHES score reflected high-quality studies (91; range 48-100). Most studies evaluating cost-effectiveness favored PGx testing. Limited data exist on cost-effectiveness of preemptive and multigene testing across disease states.