CYP3A5 pharmacogenetic testing for tacrolimus in pediatric heart transplant patients: a budget impact analysis.

IF 1.7 3区医学 Q4 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

Pharmacogenetics and genomics Pub Date : 2024-10-29 DOI:10.1097/FPC.0000000000000549

Jiaqi Wang, Amy L Pasternak, Simran Maggo, Rochelle Mindanao, Jenny Q Nguyen, Cynthia L Gong

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引用次数: 0

Abstract

Background: Pharmacogenomic testing can optimize drug efficacy and minimize adverse effects. CYP3A5 polymorphisms affect the metabolism of tacrolimus. We sought to estimate the budget impact of preemptive pharmacogenomic testing for CYP3A5 in pediatric heart transplantation patients from an institutional perspective.

Methods: A decision tree was constructed to estimate the budget impact of pediatric heart transplant patients (age ≤18 years) initiated on tacrolimus with and without CYP3A5 pharmacogenomic testing. The budget impact of preemptive pharmacogenomic testing versus no pharmacogenomic testing was calculated. One-way sensitivity analysis and alternative analyses were conducted to assess the robustness of results to changes in model parameters.

Results: CYP3A5 genotype-guided dosing provided savings of up to $17 225 per patient compared to standard dosing. These savings decreased to $11 759 when using another institution's data for the standard-dosing group. The time to achieve therapeutic concentration in the poor metabolizer genotype-guided dosing group had the largest impact on cost savings while the cost of the pharmacogenetic test had the smallest impact on cost savings.

Conclusion: Implementing CYP3A5 testing could save $17 225 per pediatric heart transplant patient receiving tacrolimus. As pharmacogenomic testing becomes more widespread, institutions should track resource requirements and outcomes to determine the best implementation policies going forward.

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小儿心脏移植患者他克莫司的 CYP3A5 药物基因检测：预算影响分析。

背景：药物基因组学检测可优化药物疗效并减少不良反应。CYP3A5 多态性会影响他克莫司的代谢。我们试图从医疗机构的角度估算对小儿心脏移植患者进行 CYP3A5 药物基因组学预先检测对预算的影响：方法：我们构建了一个决策树来估算小儿心脏移植患者（年龄≤18 岁）开始使用他克莫司时进行和未进行 CYP3A5 药物基因组学检测对预算的影响。计算了先进行药物基因组学检测与不进行药物基因组学检测的预算影响。进行了单向敏感性分析和替代分析，以评估结果对模型参数变化的稳健性：与标准剂量相比，CYP3A5 基因型指导剂量可为每位患者节省高达 17 225 美元。如果使用其他机构的数据作为标准给药组的数据，则节省的费用降至 11 759 美元。代谢不良基因型指导用药组达到治疗浓度的时间对成本节约的影响最大，而药物基因检测的成本对成本节约的影响最小：结论：实施 CYP3A5 检测可为每位接受他克莫司治疗的小儿心脏移植患者节省 17 225 美元。结论：实施 CYP3A5 检测可为每位接受他克莫司治疗的小儿心脏移植患者节省 17 225 美元。随着药物基因组学检测的普及，医疗机构应跟踪资源需求和结果，以确定今后的最佳实施政策。

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

Pharmacogenetics and genomics 医学-生物工程与应用微生物

CiteScore

3.20

自引率

3.80%

发文量

审稿时长

3 months

期刊介绍： Pharmacogenetics and Genomics is devoted to the rapid publication of research papers, brief review articles and short communications on genetic determinants in response to drugs and other chemicals in humans and animals. The Journal brings together papers from the entire spectrum of biomedical research and science, including biochemistry, bioinformatics, clinical pharmacology, clinical pharmacy, epidemiology, genetics, genomics, molecular biology, pharmacology, pharmaceutical sciences, and toxicology. Under a single cover, the Journal provides a forum for all aspects of the genetics and genomics of host response to exogenous chemicals: from the gene to the clinic.