Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/82689
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: Cost-effectiveness of using CYP2C19 genotype to guide selection of clopidogrel or ticagrelor in Australia
Author: Sorich, M.
Horowitz, J.
Sorich, W.
Wiese, M.
Pekarsky, B.
Karnon, J.
Citation: Pharmagenomics, 2013; 14(16):2013-2021
Publisher: Future Medicine Ltd
Issue Date: 2013
ISSN: 1462-2416
1744-8042
Statement of
Responsibility: 
Michael J Sorich, John D Horowitz, Wassana Sorich, Michael D Wiese, Brita Pekarsky & Jonathan D Karnon
Abstract: Aims: This study aims to assess the cost–effectiveness in Australia of screening CYP2C19 loss-of-function (LoF) alleles to guide selection of clopidogrel or ticagrelor for individuals with acute coronary syndrome who are likely to undergo coronary stenting. Methods: Three treatment strategies were compared: universal clopidogrel therapy, universal ticagrelor therapy and genotyping CYP2C19 with use of ticagrelor for individuals with a LoF allele and clopidogrel for individuals without a LoF allele. Lifetime costs and quality-adjusted life years for each treatment strategy were estimated using a Markov model. The risks of events were primarily derived from the genetic substudy of the pivotal randomized controlled trial. Results: CYP2C19 genotyping resulted in greater effectiveness and was cost-effective when compared with universal use of clopidogrel. However, universal use of ticagrelor was the most effective strategy overall and the incremental cost–effectiveness compared with the genotyping strategy was generally within what is considered acceptable. Conclusion: Ticagrelor is likely to be cost-effective even for individuals not carrying a CYP2C19 LoF allele.
Keywords: Humans; Ticlopidine; Aryl Hydrocarbon Hydroxylases; Adenosine; Markov Chains; Genotype; Alleles; Cost-Benefit Analysis; Australia; Acute Coronary Syndrome; Cytochrome P-450 CYP2C19; Clopidogrel; Ticagrelor
Rights: © 2013 Future Medicine Ltd
RMID: 0020133578
DOI: 10.2217/PGS.13.164
Appears in Collections:Medicine publications

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.