Cost-effectiveness of pharmacogenetics in anticoagulation: international differences in healthcare systems and costs

被引：13

作者：

Verhoef, Talitha I. ^{[1
]}

Redekop, William K. ^{[2
]}

van Schie, Rianne M. F. ^{[1
]}

Bayat, Samira ^{[1
]}

Daly, Ann K. ^{[3
]}

Geitona, Mary ^{[4
]}

Haschke-Becher, Elisabeth ^{[5
]}

Hughes, Dyfrig A. ^{[6
]}

Kamali, Farhad ^{[7
]}

Levin, Lars-Ake ^{[8
]}

Manolopoulos, Vangelis G. ^{[9
]}

Pirmohamed, Munir ^{[10
]}

Siebert, Uwe ^{[11
,12
,13
,14
,15
]}

Stingl, Julia C. ^{[16
]}

Wadelius, Mia ^{[17
]}

de Boer, Anthonius ^{[1
]}

Maitland-van der Zee, Anke-Hilse ^{[1
]}

机构：

[1] Univ Utrecht, Dept Pharmaceut Sci, Div Pharmacoepidemiol & Clin Pharmacol, NL-3508 TB Utrecht, Netherlands

[2] Erasmus Univ, Inst Med Technol Assessment, Rotterdam, Netherlands

[3] Newcastle Univ, Inst Cellular Med, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England

[4] Univ Peloponnese, Sch Social Policy, Corinth, Greece

[5] Elisabethinen Hosp Linz, Inst Med & Chem Lab Diagnost, Ctr Mol Diagnost & Genet, Linz, Austria

[6] Bangor Univ, Ctr Hlth Econ & Med Evaluat, Bangor, Gwynedd, Wales

[7] Newcastle Univ, Inst Cellular Med, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England

[8] Linkoping Univ, Ctr Med Technol Assessment, Linkoping, Sweden

[9] Democritus Univ Thrace, Alexandroupolis, Greece

[10] Univ Liverpool, Liverpool L69 3BX, Merseyside, England

[11] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Inst Technol Assessment, Boston, MA USA

[12] Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02115 USA

[13] ONCOTYROL Ctr Personalized Canc Med, Innsbruck, Austria

[14] UMIT Univ Hlth Sci Med Informat & Technol, Dept Publ Hlth, Hall In Tirol, Austria

[15] UMIT Univ Hlth Sci Med Informat & Technol, HTA, Hall In Tirol, Austria

[16] Univ Ulm, Ulm, Germany

[17] Uppsala Univ, Dept Med Sci, Uppsala, Sweden

来源：

PHARMACOGENOMICS | 2012年 / 13卷 / 12期

关键词：

acenocoumarol; atrial fibrillation; cost analysis; coumarins; health; economics; healthcare system; phenprocoumon; warfarin; NONVALVULAR ATRIAL-FIBRILLATION; DEEP VENOUS THROMBOSIS; ORAL ANTICOAGULATION; SELF-MANAGEMENT; BLEEDING COMPLICATIONS; WARFARIN THERAPY; INTRACEREBRAL HEMORRHAGE; DABIGATRAN ETEXILATE; ECONOMIC OUTCOMES; STROKE;

D O I：

10.2217/PGS.12.124

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Genotyping patients for CYP2C9 and VKORC1 polymorphisms can improve the accuracy of dosing during the initiation of anticoagulation with vitamin K antagonists (coumarin derivatives). The anticipated degree of improvement in the safety of anticoagulation with coumarins through genotyping may vary depending on the quality of patient care, which varies both with and among countries. The management and the cost of anticoagulant care can therefore influence the cost effectiveness of genotyping within any given country. In this article, we provide an overview of the cost effectiveness of pharmacogenetics-guided dosing of coumarin derivatives. We describe the organization of anticoagulant care in the UK, Sweden, The Netherlands, Greece, Germany and Austria, where a genotype-guided dosing algorithm is currently being investigated as part of the EU-PACT trial. We also explore the costs of anticoagulant care for the treatment of atrial fibrillation in these countries.

引用

页码：1405 / 1417

页数：13

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