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https://hdl.handle.net/2440/82689
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Type: | Journal article |
Title: | Cost-effectiveness of using CYP2C19 genotype to guide selection of clopidogrel or ticagrelor in Australia |
Author: | Sorich, M. Horowitz, J. Sorich, W. Wiese, M. Pekarsky, B. Karnon, J. |
Citation: | Pharmacogenomics, 2013; 14(16):2013-2021 |
Publisher: | Future Medicine Ltd |
Issue Date: | 2013 |
ISSN: | 1462-2416 1744-8042 |
Statement of Responsibility: | Michael J Sorich, John D Horowitz, Wassana Sorich, Michael D Wiese, Brita Pekarsky & Jonathan D Karnon |
Abstract: | Aims: This study aims to assess the cost–effectiveness in Australia of screening CYP2C19 loss-of-function (LoF) alleles to guide selection of clopidogrel or ticagrelor for individuals with acute coronary syndrome who are likely to undergo coronary stenting. Methods: Three treatment strategies were compared: universal clopidogrel therapy, universal ticagrelor therapy and genotyping CYP2C19 with use of ticagrelor for individuals with a LoF allele and clopidogrel for individuals without a LoF allele. Lifetime costs and quality-adjusted life years for each treatment strategy were estimated using a Markov model. The risks of events were primarily derived from the genetic substudy of the pivotal randomized controlled trial. Results: CYP2C19 genotyping resulted in greater effectiveness and was cost-effective when compared with universal use of clopidogrel. However, universal use of ticagrelor was the most effective strategy overall and the incremental cost–effectiveness compared with the genotyping strategy was generally within what is considered acceptable. Conclusion: Ticagrelor is likely to be cost-effective even for individuals not carrying a CYP2C19 LoF allele. |
Keywords: | Humans Ticlopidine Aryl Hydrocarbon Hydroxylases Adenosine Markov Chains Genotype Alleles Cost-Benefit Analysis Australia Acute Coronary Syndrome Cytochrome P-450 CYP2C19 Clopidogrel Ticagrelor |
Rights: | © 2013 Future Medicine Ltd |
DOI: | 10.2217/PGS.13.164 |
Published version: | http://dx.doi.org/10.2217/pgs.13.164 |
Appears in Collections: | Aurora harvest 4 Medicine publications |
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