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

Funding Agencies|EU|HEALTH-F2-2009-223062|Netherlands Organisation for Health Research and Development (ZonMW)||Dutch Health Care Insurance Board (CVZ)||Royal Dutch Pharmacists Association (KNMP)||private public funded Top Institute Pharma||EU Innovative Medicines Initiative (IMI)||FP7||Dutch Medicines Evaluation Board||Dutch Ministry of Health and industry||
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.

Redekop, William KErasmus University, Netherlands (author)
van Schie, Rianne M FUniversity of Utrecht, Netherlands (author)
Bayat, SamiraUniversity of Utrecht, Netherlands (author)
Daly, Ann KNewcastle University, England (author)
Geitona, MaryUniversity of Peloponnese, Greece (author)
Haschke-Becher, ElisabethElisabethinen Hospital Linz, Austria (author)
Hughes, Dyfrig ABangor University, Wales (author)
Kamali, FarhadNewcastle University, England (author)
Levin, Lars-ÅkeLinköpings universitet,Utvärdering och hälsoekonomi,Hälsouniversitetet(Swepub:liu)larle77 (author)
Manolopoulos, Vangelis GDemocritus University of Thrace, Greece (author)
Pirmohamed, MunirUniversity of Liverpool, England (author)
Siebert, UweHarvard University, MA USA Harvard University, MA 02115 USA ONCOTYROL Centre Personalized Cancer Med, Austria UMIT University of Health Science Medical Informat and Technology, Austria UMIT University of Health Science Medical Informat and Technology, Austria (author)
Stingl, Julia CUniversity of Ulm, Germany (author)
Wadelius, MiaUppsala universitet,Klinisk farmakologi,Uppsala University, Sweden(Swepub:uu)miawadel (author)
de Boer, AnthoniusUniversity of Utrecht, Netherlands (author)
Maitland-van der Zee, Anke-HilseUniversity of Utrecht, Netherlands (author)
University of Utrecht, NetherlandsErasmus University, Netherlands (creator_code:org_t)

In:Pharmacogenomics (London): Future Medicine13:12, s. 1405-14171462-24161744-8042

By the author/editor: Verhoef, Talitha ...; Redekop, William ...; van Schie, Riann ...; Bayat, Samira; Daly, Ann K; Geitona, Mary; show more...; Haschke-Becher, ...; Hughes, Dyfrig A; Kamali, Farhad; Levin, Lars-Åke; Manolopoulos, Va ...; Pirmohamed, Muni ...; Siebert, Uwe; Stingl, Julia C; Wadelius, Mia; de Boer, Anthoni ...; Maitland-van der ...; show less...

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