Why the study?
Does CYP2C19 genotype-guided antiplatelet therapy improve cost-effectiveness in patients following percutaneous coronary intervention?
Does CYP2C19 genotype-guided antiplatelet therapy improve cost-effectiveness in patients following percutaneous coronary intervention?
CYP2C19 genotype-guided antiplatelet therapy is likely cost-effective compared to universal clopidogrel or prasugrel following percutaneous coronary intervention.
Genotype-guided antiplatelet selection may be cost-effective post-PCI; leaves open whether adoption improves outcomes in routine care.
AIM: Determine whether using CYP2C19 genotype to optimize antiplatelet therapy selection is cost effective over the initial 30 days and 1-year following percutaneous coronary intervention. MATERIALS & METHODS: A cost-effectiveness analysis compared 30-day and 1-year outcomes and cost across three treatment strategies (universal clopidogrel, universal prasugrel, genotype-guided) in a hypothetical cohort. RESULTS: Base-case scenario results at 30 days indicated that the incremental cost per major cardiovascular or bleeding event avoided for genotype-guided treatment was US$8525 and US$42,198 compared with universal clopidogrel and prasugrel, respectively. Probabilistic sensitivity analysis demonstrated that genotype-guided treatment was cost effective over 30 days and 1 year in 62 and 70% of simulations, respectively. CONCLUSION: Implementing a CYP2C19 genotype-guided approach to antiplatelet therapy could have a positive economic impact by preventing readmissions following percutaneous coronary intervention.
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Borse et al. (2017) studied this question.
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