Cost-effectiveness of pharmacogenetic-guided dosing of warfarin in the United Kingdom and Sweden

TI Verhoef; Ken Redekop; S Langenskiold; F Kamali; M Wadelius; G Burnside; AH Maitland-van der Zee; DA Hughes; M Pirmohamed

doi:10.1038/tpj.2016.41

Cost-effectiveness of pharmacogenetic-guided dosing of warfarin in the United Kingdom and Sweden

TI Verhoef, Ken Redekop, S Langenskiold, F Kamali, M Wadelius, G Burnside, AH Maitland-van der Zee, DA Hughes, M Pirmohamed^*

^*Corresponding author for this work

Health Technology Assessment (HTA)

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Abstract

We aimed to assess the cost-effectiveness of pharmacogenetic-guided dosing of warfarin in patients with atrial fibrillation (AF) in the United Kingdom and Sweden. Data from EU-PACT, a randomized controlled trial in newly diagnosed AF patients, were used to model the incremental costs per quality-adjusted life-year (QALY) gained by pharmacogenetic-guided warfarin dosing versus standard treatment over a lifetime horizon. Incremental lifetime costs were £26 and 382 Swedish kronor (SEK) and incremental QALYs were 0.0039 and 0.0015 in the United Kingdom and Sweden, respectively. The corresponding incremental cost-effectiveness ratios (ICERs) were £6 702 and 253 848 SEK per QALY gained. The ICER was below the willingness-to-pay threshold of £20 000 per QALY gained in 93% of the simulations in the United Kingdom and below 500 000 SEK in 67% of the simulations in Sweden. Our data suggest that pharmacogenetic-guided dosing of warfarin is a cost-effective strategy to improve outcomes of patients with AF treated with warfarin in the United Kingdom and in Sweden.

Original language	English
Pages (from-to)	478-484
Number of pages	7
Journal	Pharmacogenomics Journal
Volume	16
Issue number	5
DOIs	https://doi.org/10.1038/tpj.2016.41
Publication status	Published - 7 Jun 2016

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Costeffectiveness_of_pharmacogFinal published version, 407 KBLicence: Article 25fa Dutch Copyright Act

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title = "Cost-effectiveness of pharmacogenetic-guided dosing of warfarin in the United Kingdom and Sweden",

abstract = "We aimed to assess the cost-effectiveness of pharmacogenetic-guided dosing of warfarin in patients with atrial fibrillation (AF) in the United Kingdom and Sweden. Data from EU-PACT, a randomized controlled trial in newly diagnosed AF patients, were used to model the incremental costs per quality-adjusted life-year (QALY) gained by pharmacogenetic-guided warfarin dosing versus standard treatment over a lifetime horizon. Incremental lifetime costs were £26 and 382 Swedish kronor (SEK) and incremental QALYs were 0.0039 and 0.0015 in the United Kingdom and Sweden, respectively. The corresponding incremental cost-effectiveness ratios (ICERs) were £6 702 and 253 848 SEK per QALY gained. The ICER was below the willingness-to-pay threshold of £20 000 per QALY gained in 93% of the simulations in the United Kingdom and below 500 000 SEK in 67% of the simulations in Sweden. Our data suggest that pharmacogenetic-guided dosing of warfarin is a cost-effective strategy to improve outcomes of patients with AF treated with warfarin in the United Kingdom and in Sweden.",

author = "TI Verhoef and Ken Redekop and S Langenskiold and F Kamali and M Wadelius and G Burnside and {Maitland-van der Zee}, AH and DA Hughes and M Pirmohamed",

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AU - Verhoef, TI

AU - Redekop, Ken

AU - Langenskiold, S

AU - Kamali, F

AU - Wadelius, M

AU - Burnside, G

AU - Maitland-van der Zee, AH

AU - Hughes, DA

AU - Pirmohamed, M

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N2 - We aimed to assess the cost-effectiveness of pharmacogenetic-guided dosing of warfarin in patients with atrial fibrillation (AF) in the United Kingdom and Sweden. Data from EU-PACT, a randomized controlled trial in newly diagnosed AF patients, were used to model the incremental costs per quality-adjusted life-year (QALY) gained by pharmacogenetic-guided warfarin dosing versus standard treatment over a lifetime horizon. Incremental lifetime costs were £26 and 382 Swedish kronor (SEK) and incremental QALYs were 0.0039 and 0.0015 in the United Kingdom and Sweden, respectively. The corresponding incremental cost-effectiveness ratios (ICERs) were £6 702 and 253 848 SEK per QALY gained. The ICER was below the willingness-to-pay threshold of £20 000 per QALY gained in 93% of the simulations in the United Kingdom and below 500 000 SEK in 67% of the simulations in Sweden. Our data suggest that pharmacogenetic-guided dosing of warfarin is a cost-effective strategy to improve outcomes of patients with AF treated with warfarin in the United Kingdom and in Sweden.

AB - We aimed to assess the cost-effectiveness of pharmacogenetic-guided dosing of warfarin in patients with atrial fibrillation (AF) in the United Kingdom and Sweden. Data from EU-PACT, a randomized controlled trial in newly diagnosed AF patients, were used to model the incremental costs per quality-adjusted life-year (QALY) gained by pharmacogenetic-guided warfarin dosing versus standard treatment over a lifetime horizon. Incremental lifetime costs were £26 and 382 Swedish kronor (SEK) and incremental QALYs were 0.0039 and 0.0015 in the United Kingdom and Sweden, respectively. The corresponding incremental cost-effectiveness ratios (ICERs) were £6 702 and 253 848 SEK per QALY gained. The ICER was below the willingness-to-pay threshold of £20 000 per QALY gained in 93% of the simulations in the United Kingdom and below 500 000 SEK in 67% of the simulations in Sweden. Our data suggest that pharmacogenetic-guided dosing of warfarin is a cost-effective strategy to improve outcomes of patients with AF treated with warfarin in the United Kingdom and in Sweden.

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JO - Pharmacogenomics Journal

JF - Pharmacogenomics Journal

IS - 5

ER -

Cost-effectiveness of pharmacogenetic-guided dosing of warfarin in the United Kingdom and Sweden

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