Cost analysis of CYP2C19 genetic testing in percutaneous coronary intervention patients.

IF 2.9 3区 医学 Q2 GENETICS & HEREDITY Pharmacogenomics Journal Pub Date : 2024-10-08 DOI:10.1038/s41397-024-00353-y
Samuel Huxley, James Moriarty, Mark A Hlatky, Ryan Lennon, Kent Bailey, Malcolm Bell, Nancy Geller, Amir Lerman, Verghese Mathew, Yves Rosenberg, Michael Farkouh, Charanjit Rihal, Bijan Borah, Naveen L Pereira
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Abstract

CYP2C19 loss of function (LOF) carriers undergoing percutaneous coronary intervention (PCI) have an increased risk of ischemic events when treated with clopidogrel. PCI patients in TAILOR-PCI were randomized to clopidogrel or genotype-guided (GG) therapy in which LOF carriers received ticagrelor and non-carriers clopidogrel. Direct medical costs associated with a GG approach have not been described before. TAILOR-PCI participants for whom direct medical costs were available for the duration from the date of PCI to one-year post PCI were included. Primary cost estimates were obtained from the Mayo Clinic Cost Data Warehouse. There were no differences in direct medical costs between the GG and clopidogrel groups (mean $20,682 versus $19,747, p = 0.11) however total costs were greater in the GG group (mean $21,245 versus $19,891, p = 0.02) which was primarily driven by ticagrelor costs. In conclusion the increased expense of a GG strategy post PCI as compared to clopidogrel for all is primarily driven by the cost of ticagrelor.

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经皮冠状动脉介入治疗患者的 CYP2C19 基因检测成本分析。
接受经皮冠状动脉介入治疗(PCI)的CYP2C19功能缺失(LOF)携带者在接受氯吡格雷治疗时发生缺血性事件的风险会增加。TAILOR-PCI中的PCI患者随机接受氯吡格雷或基因型指导(GG)疗法,其中LOF携带者接受替卡格雷治疗,非携带者接受氯吡格雷治疗。与 GG 方法相关的直接医疗成本以前从未描述过。TAILOR-PCI的参与者从PCI之日起至PCI术后一年内的直接医疗费用均可获得。主要成本估算来自梅奥诊所成本数据仓库。GG组和氯吡格雷组的直接医疗费用没有差异(平均为20,682美元对19,747美元,P = 0.11),但GG组的总费用更高(平均为21,245美元对19,891美元,P = 0.02),这主要是由替卡格雷费用引起的。总之,与氯吡格雷相比,PCI 后 GG 策略的费用增加主要是由替卡格雷的费用造成的。
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来源期刊
Pharmacogenomics Journal
Pharmacogenomics Journal 医学-药学
CiteScore
7.20
自引率
0.00%
发文量
35
审稿时长
6-12 weeks
期刊介绍: The Pharmacogenomics Journal is a print and electronic journal, which is dedicated to the rapid publication of original research on pharmacogenomics and its clinical applications. Key areas of coverage include: Personalized medicine Effects of genetic variability on drug toxicity and efficacy Identification and functional characterization of polymorphisms relevant to drug action Pharmacodynamic and pharmacokinetic variations and drug efficacy Integration of new developments in the genome project and proteomics into clinical medicine, pharmacology, and therapeutics Clinical applications of genomic science Identification of novel genomic targets for drug development Potential benefits of pharmacogenomics.
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