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Genetic testing not cost-effective in guiding initial dosing of common blood thinner
Date:1/19/2009

ty-adjusted life year gained.

In other analyses, where they took into consideration the limitations of the studies, researchers found that there is only a 10 percent chance that genotype-guided dosing is likely to be cost-effective.

Researchers also looked at the impact of other variables on the cost-effectiveness of genotype-guided dosing.

Eckman says results show that genotype-guided dosing might be worth the costs if it:

  • Is used for patients at high risk for hemorrhage
  • Prevents more than 32 percent of major bleeding events
  • Is available within 24 hours
  • Costs less than $200

"This could be accomplished if testing were done in-house, at lower cost and without delays," he says, noting that currently in most cases these tests need to be sent to outside laboratories which can lead to delays in starting treatment and increased cost. "Furthermore, future studies, such as the recently funded National Institutes of Health COAG trial, need to examine the impact of pharmacogenetic-guided dosing on bleeding risk and monitor outcomes long enough to determine the true duration of benefit."

Eckman also suggests that rather than excluding patients at higher risk for bleeding, studies should offer enrollment if it has already been determined that these patients require warfarin.

"Personalized, predictive medicine offers great promise, but we need to carefully examine the benefits and understand the cost-effectiveness of such strategies before we spend a lot of money on very expensive tests."


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Contact: Katie Pence
katie.pence@uc.edu
513-558-4561
University of Cincinnati
Source:Eurekalert

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