{"id":12647,"date":"2020-02-05T21:57:00","date_gmt":"2020-02-06T05:57:00","guid":{"rendered":"https:\/\/oslc.nineplanetsllc.com\/blog\/publication\/cost-effectiveness-of-multi-gene-pharmacogenetic-testing-in-acute-coronary-syndrome-patients-following-percutaneous-coronary-intervention\/"},"modified":"2023-04-13T15:39:06","modified_gmt":"2023-04-13T22:39:06","slug":"cost-effectiveness-of-multi-gene-pharmacogenetic-testing-in-acute-coronary-syndrome-patients-following-percutaneous-coronary-intervention","status":"publish","type":"publication","link":"https:\/\/www.oslc.org\/es\/blog\/publication\/cost-effectiveness-of-multi-gene-pharmacogenetic-testing-in-acute-coronary-syndrome-patients-following-percutaneous-coronary-intervention\/","title":{"rendered":"Cost-effectiveness of multi-gene pharmacogenetic testing in acute coronary syndrome patients following percutaneous coronary intervention"},"content":{"rendered":"<p><strong>Objective: <\/strong>To evaluate the cost-effectiveness of multigene testing (<em>CYP2C19, SLCO1B1, CYP2C9, VKORC1<\/em>) compared with single-gene testing (<em>CYP2C19<\/em>) and standard of care (no genotyping) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) from Medicare\u2019s perspective. <strong>Methods: <\/strong>A hybrid decision tree\/Markov model was developed to simulate patients post-PCI for ACS requiring antiplatelet therapy (<em>CYP2C19<\/em> to guide antiplatelet selection), statin therapy (<em>SLCO1B1<\/em> to guide statin selection), and anticoagulant therapy in those that develop atrial fibrillation (<em>CYP2C9\/VKORC1<\/em> to guide warfarin dose) over 12 months, 24 months, and lifetime. The primary outcome was cost (2016 US dollar) per quality-adjusted life years (QALYs) gained. Costs and QALYs were discounted at 3% per year. Probabilistic sensitivity analysis (PSA) varied input parameters (event probabilities, prescription costs, event costs, health-state utilities) to estimate changes in the cost per QALY gained. <strong>Results: <\/strong>Base-case\u2013discounted results indicated that the cost per QALY gained was $59 876, $33 512, and $3780 at 12 months, 24 months, and lifetime, respectively, for multigene testing compared with standard of care. Single-gene testing was dominated by multigene testing at all time horizons. PSA-discounted results indicated that, at the $50 000\/QALY gained willingness-to-pay threshold, multigene testing had the highest probability of cost-effectiveness in the majority of simulations at 24 months (61%) and over the lifetime (81%). <strong>Conclusions: <\/strong>On the basis of projected simulations, multigene testing for Medicare patients post-PCI for ACS has a higher probability of being cost-effective over 24 months and the lifetime compared with single-gene testing and standard of care and could help optimize medication prescribing to improve patient outcomes.<\/p>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false,"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","_seopress_analysis_target_kw":"","site-sidebar-layout":null,"site-content-layout":null,"ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":null,"ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":null,"ast-breadcrumbs-content":null,"ast-featured-img":null,"footer-sml-layout":null,"ast-disable-related-posts":"","theme-transparent-header-meta":null,"adv-header-id-meta":null,"stick-header-meta":null,"header-above-stick-meta":null,"header-main-stick-meta":null,"header-below-stick-meta":null,"astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}}},"publication_keyword":[1464,1465,1466,1467],"research_type":[10],"class_list":["post-12647","publication","type-publication","status-publish","hentry","publication_keyword-acute-coronary-syndrome","publication_keyword-multigene-testing","publication_keyword-pharmacogenetics","publication_keyword-precision-medicine","research_type-basic"],"acf":{"citation":"Dong, O., Wheeler, S. B., Cruden, G., Lee, C. R., Voora, D., Dusetzina, S. B., &amp; Wiltshire, T. (2020). Cost-effectiveness of multi-gene pharmacogenetic testing in acute coronary syndrome patients following percutaneous coronary intervention. <em>Value in Health, 23<\/em>, 61-73. doi:10.1016\/j.jval.2019.08.002","publication_year":"2020","scientists":[11082]},"_links":{"self":[{"href":"https:\/\/www.oslc.org\/es\/wp-json\/wp\/v2\/publication\/12647","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.oslc.org\/es\/wp-json\/wp\/v2\/publication"}],"about":[{"href":"https:\/\/www.oslc.org\/es\/wp-json\/wp\/v2\/types\/publication"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.oslc.org\/es\/wp-json\/wp\/v2\/scientist\/11082"}],"wp:attachment":[{"href":"https:\/\/www.oslc.org\/es\/wp-json\/wp\/v2\/media?parent=12647"}],"wp:term":[{"taxonomy":"publication_keyword","embeddable":true,"href":"https:\/\/www.oslc.org\/es\/wp-json\/wp\/v2\/publication_keyword?post=12647"},{"taxonomy":"research_type","embeddable":true,"href":"https:\/\/www.oslc.org\/es\/wp-json\/wp\/v2\/research_type?post=12647"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}