A model for cost effectiveness analysis of using genetic information of oral anticoagulation patients

F. Archetti, I. Giordani, E. Messina, D. Maccagnola, G. Ogliari, D. Mari

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Oral anticoagulation therapy, largely performed by warfarin-based drugs, is commonly used for patients with a high risk of blood clotting which can lead to stroke or thrombosis. The state of the patient, with respect to anticoagulation, is captured by the index INR, which is to be kept within a therapeutic range. The patient's response is marked by high inter-individual and intertemporal variability, which can lead to serious adverse events. The Food and Drug Administration's Adverse Event Reporting System indicated that warfarin is among the 10 top drugs for the adverse events reported during the 1990 and 2000 decades. Moreover in the last years genetic testing has been argued as a base to personalize dosing. For these reasons there is no widely agreed conclusion as to whether the net economic results, i.e. keeping the cost of testing into account, of the therapeutic improvement allowed by genetic testing are positive. In this paper the authors develop a model based on a decision tree to assess the cost-effectiveness of genotype based warfarin dosing. Clinical/therapeutical data inputs for the model have been derived from a database of nearly 4000 patients; among them 350 patients have been so far genotyped. Several scenarios have been simulated about the prevalence of major bleeding and their reduction rates that, following the literature, can be due to genotyped dosing.

Original languageEnglish
Title of host publication2010 IEEE Workshop on Health Care Management, WHCM 2010
DOIs
Publication statusPublished - 2010
Event2010 IEEE Workshop on Health Care Management, WHCM 2010 - Venice, Italy
Duration: Feb 18 2010Feb 20 2010

Other

Other2010 IEEE Workshop on Health Care Management, WHCM 2010
CountryItaly
CityVenice
Period2/18/102/20/10

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)

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    Archetti, F., Giordani, I., Messina, E., Maccagnola, D., Ogliari, G., & Mari, D. (2010). A model for cost effectiveness analysis of using genetic information of oral anticoagulation patients. In 2010 IEEE Workshop on Health Care Management, WHCM 2010 [5441249] https://doi.org/10.1109/WHCM.2010.5441249