Genetic-guided pharmacotherapy for venous thromboembolism: a systematic and critical review of economic evaluations.
Adolescent
Adult
Child
Child, Preschool
Clinical Decision-Making
Cost-Benefit Analysis
Drug Costs
Female
Fibrinolytic Agents
/ adverse effects
Genetic Predisposition to Disease
Hemorrhage
/ chemically induced
Humans
Male
Middle Aged
Pharmacogenomic Testing
/ economics
Pharmacogenomic Variants
Phenotype
Precision Medicine
/ economics
Predictive Value of Tests
Recurrence
Risk Assessment
Risk Factors
Treatment Outcome
Venous Thromboembolism
/ drug therapy
Young Adult
Journal
The pharmacogenomics journal
ISSN: 1473-1150
Titre abrégé: Pharmacogenomics J
Pays: United States
ID NLM: 101083949
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
19
01
2021
accepted:
19
05
2021
revised:
12
05
2021
pubmed:
17
6
2021
medline:
11
3
2022
entrez:
16
6
2021
Statut:
ppublish
Résumé
Despite the known contributions of genes, genetic-guided pharmacotherapy has not been routinely implemented for venous thromboembolism (VTE). To examine evidence on cost-effectiveness of genetic-guided pharmacotherapy for VTE, we searched six databases, websites of four HTA agencies and citations, with independent double-reviewers in screening, data extraction, and quality rating. The ten eligible studies, all model-based, examined heterogeneous interventions and comparators. Findings varied widely; testing was cost-saving in two base-cases, cost-effective in four, not cost-effective in three, dominated in one. Of 22 model variables that changed decisions about cost-effectiveness, effectiveness/relative effectiveness of the intervention was the most frequent, albeit of poor quality. Studies consistently lacked details on the provision of interventions and comparators as well as on model development and validation. Besides improving the reporting of interventions, comparators, and methodological details, future economic evaluations should examine strategies recommended in guidelines and testing key model variables for decision uncertainty, to advise clinical implementations.
Identifiants
pubmed: 34131314
doi: 10.1038/s41397-021-00243-7
pii: 10.1038/s41397-021-00243-7
pmc: PMC8602036
doi:
Substances chimiques
Fibrinolytic Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
625-637Subventions
Organisme : Medical Research Council
ID : MR/M016560/1
Pays : United Kingdom
Organisme : British Heart Foundation
ID : SP/14/8/31352
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
© 2021. The Author(s).
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