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Genetic-guided pharmacotherapy for venous thromboembolism: a systematic and critical review of economic evaluations

Research output: Contribution to journalReview articlepeer-review

Original languageEnglish
Pages (from-to)625-637
Number of pages13
JournalPharmacogenomics Journal
Volume21
Issue number6
Early online date15 Jun 2021
DOIs
Accepted/In press2021
E-pub ahead of print15 Jun 2021
PublishedDec 2021

Bibliographical note

Funding Information: Funding The research was funded by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Publisher Copyright: © 2021, The Author(s).

King's Authors

Abstract

Despite the known contributions of genes, genetic-guided pharmacotherapy has not been routinely implemented for venous thromboembolism (VTE). To examine evidence on cost-effectiveness of genetic-guided pharmacotherapy for VTE, we searched six databases, websites of four HTA agencies and citations, with independent double-reviewers in screening, data extraction, and quality rating. The ten eligible studies, all model-based, examined heterogeneous interventions and comparators. Findings varied widely; testing was cost-saving in two base-cases, cost-effective in four, not cost-effective in three, dominated in one. Of 22 model variables that changed decisions about cost-effectiveness, effectiveness/relative effectiveness of the intervention was the most frequent, albeit of poor quality. Studies consistently lacked details on the provision of interventions and comparators as well as on model development and validation. Besides improving the reporting of interventions, comparators, and methodological details, future economic evaluations should examine strategies recommended in guidelines and testing key model variables for decision uncertainty, to advise clinical implementations.

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