Cost-effectiveness of HLA-B58:01* testing to prevent Stevens-Johnson syndrome/toxic epidermal necrolysis in Vietnam.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-08-01 Epub Date: 2023-09-14 DOI:10.2217/pgs-2023-0095

Khanh Nc Duong, Dinh Van Nguyen, Nathorn Chaiyakunapruk, Richard E Nelson, Daniel C Malone

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引用次数: 0

Abstract

Background: HLA-B*58:01 is strongly associated with allopurinol-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in Vietnam. This study assessed the cost-effectiveness of this testing to prevent SJS/TEN. Methods: A model was developed to compare three strategies: no screening, use allopurinol; HLA-B*58:01 screening; and no screening, use probenecid. A willingness-to-pay of three-times gross domestic product per capita was used. Results: Compared with 'no screening, use allopurinol', 'screening' increased quality-adjusted life-years by 0.0069 with the incremental cost of Vietnam dong (VND) 14,283,633 (US$617), yielding an incremental cost-effectiveness ratio of VND 2,070,459,122 (US$89,398) per quality-adjusted life-year. Therefore, 'screening' was unlikely to be cost-effective under the current willingness-to-pay. Testing's cost-effectiveness may change with targeted high-risk patients, reimbursed febuxostat or lower probenecid prices. Conclusion: The implementation of nationwide HLAB*58:01 testing before the use of allopurinol is not cost-effective, according to this analysis. This may be due to the lack of quality data on the effectiveness of testing and costing data in the Vietnamese population.

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HLA-B*58:01检测预防越南Stevens-Johnson综合征/中毒性表皮坏死松解症的成本效益。

背景：HLA-B*58:01与越南别嘌呤醇诱导的Stevens-Johnson综合征/中毒性表皮坏死松解症（SJS/TEN）密切相关。本研究评估了该测试预防SJS/TEN的成本效益。方法：建立模型比较三种策略：不筛查、使用别嘌醇；HLA-B*58:01筛查；不用筛选，用丙磺舒。使用了人均国内生产总值三倍的支付意愿。结果：与“不进行筛查，使用别嘌醇”相比，“筛查”使质量调整后的生命年增加了0.0069，增加费用为14283633越南盾（617美元），每个质量调整后生命年的成本效益比增加了2070459122越南盾（89398美元）。因此，在目前的支付意愿下，“筛查”不太可能具有成本效益。检测的成本效益可能会随着目标高危患者、非布司他报销或丙磺舒价格的降低而改变。结论：根据该分析，在别嘌醇使用前实施全国范围的HLAB*58:01检测是不划算的。这可能是由于缺乏关于越南人口中检测有效性和成本数据的高质量数据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.