A Cost-Effectiveness Analysis of Biomarkers for Risk Prediction in Atrial Fibrillation.

IF 4.1 3区医学 Q1 GENETICS & HEREDITY

Molecular Diagnosis & Therapy Pub Date : 2023-05-01 Epub Date: 2023-01-31 DOI:10.1007/s40291-023-00639-0

Gisèle Nakhlé, Jean-Claude Tardif, Denis Roy, Léna Rivard, Michelle Samuel, Anick Dubois, Jacques LeLorier

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引用次数: 0

Abstract

Rationale: Atrial fibrillation (AF) is associated with an increased risk of thromboembolism. This risk is currently assessed with scoring systems based on clinical characteristics. However, these tools have limited prognostic performance. Circulating biomarkers are proposed for improved prediction of major clinical events and individualization of treatments in patients with AF.

Objective: The aim was to assess the cost-effectiveness of precision medicine (PM), i.e., the use of combined biomarkers and clinical variables, in comparison to standard of care (SOC) for risk stratification in a hypothetical cohort of AF patients at risk of stroke.

Methods: A Markov cohort model was developed to evaluate the costs and quality-adjusted life-years (QALYs) of PM compared to SOC, over 20 years using a Canadian healthcare system perspective.

Results: PM decreased the mean per-patient overall costs by 7% ($94,932 vs $102,057 [Canadian dollars], respectively) and increased the QALYs by 12% (8.77 vs 7.68 QALYs, respectively). The calculated incremental cost-effectiveness ratio was negative, indicating that PM is an economically dominant strategy. These results were robust to one-way and probabilistic sensitivity analyses.

Conclusion: PM compared to SOC is economically dominant and is projected to generate cost savings.

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心房颤动风险预测生物标记物的成本效益分析

理由心房颤动（房颤）与血栓栓塞风险增加有关。目前，这种风险是通过基于临床特征的评分系统来评估的。然而，这些工具的预后效果有限。有人建议使用循环生物标志物来改进房颤患者主要临床事件的预测和个体化治疗：目的：评估精准医疗（PM）的成本效益，即在有中风风险的房颤患者假定队列中使用生物标记物和临床变量进行风险分层，并与标准护理（SOC）进行比较：方法：从加拿大医疗保健系统的角度出发，建立了一个马尔可夫队列模型，以评估 PM 与 SOC 相比在 20 年内的成本和质量调整生命年（QALYs）：结果： PM使每位患者的平均总成本降低了7%（分别为94,932加元与102,057加元[加元]），QALYs增加了12%（分别为8.77 QALYs与7.68 QALYs）。计算出的增量成本效益比为负值，表明 PM 是一种经济上占优势的策略。这些结果对单向和概率敏感性分析都是稳健的：PM 与 SOC 相比在经济上占主导地位，预计可节约成本。

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

Molecular Diagnosis & Therapy 医学-药学

CiteScore

7.80

自引率

2.50%

发文量

审稿时长

>12 weeks

期刊介绍： Molecular Diagnosis & Therapy welcomes current opinion articles on emerging or contentious issues, comprehensive narrative reviews, systematic reviews (as outlined by the PRISMA statement), original research articles (including short communications) and letters to the editor. All manuscripts are subject to peer review by international experts.