HEALTH ECONOMICS OF PHARMACOGENETIC TESTING

Abstract

SOME COMMONLY USED MEDICATIONS CAN CAUSE A LIFE-THREATENING ADVERSE DRUG REACTION NAMED STEVENS-JOHNSON SYNDROME (SJS). THOUGH THE GENETIC RISK FACTORS HAVE BEEN WELL ESTABLISHED, ADOPTION OF PHARMACOGENETIC TESTING TO REDUCE SJS RISK IN CLINICAL CARE HAS BEEN SLOW. I CONDUCT HEALTH ECONOMIC EVALUATIONS TO INFORM CLINICAL AND REGULATORY DECISION MAKING ON WHETHER PHARMACOGENETIC TESTING SHOULD BE DONE TO REDUCE THE RISK OF SJS IN SINGAPORE. I FIRST ASSESSED THE COST-EFFECTIVENESS OF TWO PHARMACOGENETIC TESTS FROM A HEALTH SYSTEM PERSPECTIVE, AND FOUND THAT GENOTYPING EPILEPSY PATIENTS FOR HLA-B*1502 PRIOR TO CARBAMAZEPINE TREATMENT WAS HIGHLY COST-EFFECTIVE, WHEREAS GENOTYPING CHRONIC GOUT PATIENTS FOR HLA-B*5801 PRIOR TO ALLOPURINOL TREATMENT WAS NOT COST-EFFECTIVE IN SINGAPORE. I THEN MEASURED PATIENTS? PREFERENCES FOR PHARMACOGENETIC TESTING IN CHRONIC GOUT TREATMENT. RESULTS SUGGESTED THAT RISK OF SJS, COST OF GENOTYPING, COST OF GOUT TREATMENT, DOCTOR?S RECOMMENDATION AND CHOICE