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Cost-effectiveness of one-time genetic testing to minimize lifetime adverse drug reactions

机译:一次性基因检测的成本效益,可最大程度地减少终生药物不良反应

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We evaluated the cost-effectiveness of one-time pharmacogenomic testing for preventing adverse drug reactions (ADRs) over a patient's lifetime. We developed a Markov-based Monte Carlo microsimulation model to represent the ADR events in the lifetime of each patient. The base-case considered a 40-year-old patient. We measured health outcomes in life years (LYs) and quality-adjusted LYs (QALYs) and estimated costs using 2013 US$. In the base-case, one-time genetic testing had an incremental cost-effectiveness ratio (ICER) of $43 165 (95% confidence interval (CI) is ($42 769,$43 561)) per additional LY and $53 680 per additional QALY (95% CI is ($53 182,$54 179)), hence under the base-case one-time genetic testing is cost-effective. The ICER values were most sensitive to the average probability of death due to ADR, reduction in ADR rate due to genetic testing, mean ADR rate and cost of genetic testing.
机译:我们评估了一次药物基因组学测试在患者一生中预防药物不良反应(ADR)的成本效益。我们开发了一个基于马尔可夫的蒙特卡洛微观模拟模型来代表每个患者一生中的ADR事件。该基本病例被认为是40岁的患者。我们以生命年(LYs)和质量调整后的LYs(QALYs)衡量了健康结局,并使用2013年美元汇率估算了成本。在基本情况下,一次性基因检测的每增加一个LY的成本效益比(ICER)为43 165美元(95%置信区间(CI)为(42 769美元,43 561美元)),每增加一个QALY成本效益比为53 680美元(95%的可信区间为(53 182美元,54 179美元)),因此在基本情况下,一次性基因测试是具有成本效益的。 ICER值对ADR导致的平均死亡概率,基因检测导致的ADR率降低,平均ADR率和基因检测成本最敏感。

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