CYP2C19-guided antiplatelet therapy: A cost-effectiveness analysis of 30-day and 1-year outcomes following percutaneous coronary intervention

Mrudula S. Borse, Olivia M. Dong, Melissa J. Polasek, Joel F. Farley, George A. Stouffer, Craig R. Lee

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Aim: Determine whether using CYP2C19 genotype to optimize antiplatelet therapy selection is cost effective over the initial 30 days and 1-year following percutaneous coronary intervention. Materials & methods: A cost-effectiveness analysis compared 30-day and 1-year outcomes and cost across three treatment strategies (universal clopidogrel, universal prasugrel, genotype-guided) in a hypothetical cohort. Results: Base-case scenario results at 30 days indicated that the incremental cost per major cardiovascular or bleeding event avoided for genotype-guided treatment was US8525 and US42,198 compared with universal clopidogrel and prasugrel, respectively. Probabilistic sensitivity analysis demonstrated that genotype-guided treatment was cost effective over 30 days and 1 year in 62 and 70% of simulations, respectively. Conclusion: Implementing a CYP2C19 genotype-guided approach to antiplatelet therapy could have a positive economic impact by preventing readmissions following percutaneous coronary intervention.

Original languageEnglish (US)
Pages (from-to)1155-1166
Number of pages12
JournalPharmacogenomics
Volume18
Issue number12
DOIs
StatePublished - Aug 2017

Bibliographical note

Publisher Copyright:
© 2017 2017 Future Medicine Ltd.

Keywords

  • CYP2C19
  • clopidogrel
  • cost-effectiveness
  • genotype
  • pharmacogenomics
  • prasugrel
  • readmission

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