Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature
Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature
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DOI：
10.1371/journal.pone.0146262
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发表时间：
2016-01-11
期刊：
影响因子：
3.7
通讯作者：
Postma, Maarten J.
中科院分区：
文献类型：
--
作者：
Berm, Elizabeth J. J.;de Looff, Margot;Postma, Maarten J.
目的随着药物遗传学和药物基因组筛选(PGx)试验的广泛应用，评估它们是否物有所值是很重要的。方法计算机检索PubMed的文献，纳入2010年8月至2014年9月发表的研究前列腺素X筛查试验成本-效果的文章。通过之前的两次系统评价纳入了2000年至2010年7月的论文。结果共发现38篇研究，与之前的42篇研究相结合，共纳入80篇研究。QHES平均得分为76分。自2010年以来，更多的研究得到了制药公司的资助。最近的大多数研究进行了成本效用分析、单变量和概率敏感性分析，并讨论了其经济评估的局限性。大多数研究表明具有良好的成本效益。大多数评估没有提供有关PGx测试的内在价值的信息。PGx检测的费用有相当大的差异。关于成本效益估计的偏差的方向和大小以及所选经济模型和观点的动机的报告经常被遗漏。结论应用PGx测试被发现大多是一种成本效益或成本节约的策略。我们发现，最近的药物经济学评估中只有少数评估了PGx试验的内在价值。研究的数量和报告质量相关特征的数量有所增加。为了改进未来的评估，建议进行情景分析，包括广泛的PGx测试成本和比较药物的同等成本，以评估PGx测试的内在价值。此外，关于PGx试验有效性的强有力的临床证据仍然是至关重要的。
ObjectiveDue to extended application of pharmacogenetic and pharmacogenomic screening (PGx) tests it is important to assess whether they provide good value for money. This review provides an update of the literature.MethodsA literature search was performed in PubMed and papers published between August 2010 and September 2014, investigating the cost-effectiveness of PGx screening tests, were included. Papers from 2000 until July 2010 were included via two previous systematic reviews. Studies' overall quality was assessed with the Quality of Health Economic Studies (QHES) instrument.ResultsWe found 38 studies, which combined with the previous 42 studies resulted in a total of 80 included studies. An average QHES score of 76 was found. Since 2010, more studies were funded by pharmaceutical companies. Most recent studies performed cost-utility analysis, univariate and probabilistic sensitivity analyses, and discussed limitations of their economic evaluations. Most studies indicated favorable cost-effectiveness. Majority of evaluations did not provide information regarding the intrinsic value of the PGx test. There were considerable differences in the costs for PGx testing. Reporting of the direction and magnitude of bias on the cost-effectiveness estimates as well as motivation for the chosen economic model and perspective were frequently missing.ConclusionsApplication of PGx tests was mostly found to be a cost-effective or cost-saving strategy. We found that only the minority of recent pharmacoeconomic evaluations assessed the intrinsic value of the PGx tests. There was an increase in the number of studies and in the reporting of quality associated characteristics. To improve future evaluations, scenario analysis including a broad range of PGx tests costs and equal costs of comparator drugs to assess the intrinsic value of the PGx tests, are recommended. In addition, robust clinical evidence regarding PGx tests' efficacy remains of utmost importance.