Real-world cost-effectiveness of pharmacogenetic screening for epilepsy treatment

Neurology
Zhibin ChenPatrick Kwan

Abstract

To assess the cost-effectiveness of the HLA-B*15:02 screening policy for the treatment of epilepsy in Hong Kong. From all public hospitals and clinics in Hong Kong, 13,231 patients with epilepsy who started their first antiepileptic drug (AED) between September 16, 2005, and September 15, 2011 (3 years before and 3 years after policy implementation on September 16, 2015), were identified retrospectively. A decision tree model was constructed to incorporate the real-world data on AED prescription patterns, incidences of AED-induced Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), costs of AED treatments, SJS/TEN treatment, and HLA-B*15:02 testing, and quality of life. Cost-effectiveness of the screening policy was analyzed for 3 scenarios: (1) current real-world situation, (2) "ideal" situation assuming full policy adherence and preferable testing practices, and (3) "extended" situation simulating the extension of HLA-B*15:02 screening to phenytoin in ideal practice. The current screening policy was associated with an incremental cost-effectiveness ratio of US $85,697 per quality-adjusted life year (QALY) compared with no screening. The incremental cost-effectiveness ratio was estimated to be US $11,090/QALY in t...Continue Reading

References

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Citations

Feb 19, 2016·Neurology·Anthony Marson, Renzo Guerrini
Oct 30, 2016·Current Opinion in Immunology·Patricia T IllingAnthony W Purcell
Apr 26, 2017·Journal of Clinical Laboratory Analysis·Guigao LinJinming Li
Jun 29, 2018·Epilepsia·Eugen TrinkaAmitabh Dash
Jun 19, 2018·Expert Review of Pharmacoeconomics & Outcomes Research·Melissa H RobertsMatthew E Borrego
Nov 1, 2018·Pharmacogenetics and Genomics·Ching-Hua KeChien-Ning Hsu
Nov 23, 2018·Clinical Pharmacology and Therapeutics·Catrin O PlumptonDyfrig A Hughes
Apr 5, 2019·Expert Opinion on Drug Safety·Sameer Sharma, Patrick Kwan
Dec 4, 2016·Neurology·Chun-Bing ChenUNKNOWN Taiwan Severe Cutaneous Adverse Reaction Consortium
Dec 28, 2019·Pharmaceutics·Stefano FortinguerraAlessandro Buriani
Jul 12, 2017·Immunogenetics·Patricia T IllingJames McCluskey
Oct 3, 2020·Annual Review of Pharmacology and Toxicology·Wan-Chun ChangBruce C Carleton
Aug 24, 2018·Deutsches Ärzteblatt International·Ruwen BöhmIngolf Cascorbi

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