Cost-effectiveness of pharmacogenetic-guided dosing of warfarin in the United Kingdom and Sweden.

Verhoef TI, Redekop WK, Langenskiold S, Kamali F, Wadelius M, Burnside G, Maitland-van der Zee AH, Hughes DA, Pirmohamed M

Pharmacogenomics J. 16 (5) 478-484 [2016-10-00; online 2016-06-07]

We aimed to assess the cost-effectiveness of pharmacogenetic-guided dosing of warfarin in patients with atrial fibrillation (AF) in the United Kingdom and Sweden. Data from EU-PACT, a randomized controlled trial in newly diagnosed AF patients, were used to model the incremental costs per quality-adjusted life-year (QALY) gained by pharmacogenetic-guided warfarin dosing versus standard treatment over a lifetime horizon. Incremental lifetime costs were £26 and 382 Swedish kronor (SEK) and incremental QALYs were 0.0039 and 0.0015 in the United Kingdom and Sweden, respectively. The corresponding incremental cost-effectiveness ratios (ICERs) were £6 702 and 253 848 SEK per QALY gained. The ICER was below the willingness-to-pay threshold of £20 000 per QALY gained in 93% of the simulations in the United Kingdom and below 500 000 SEK in 67% of the simulations in Sweden. Our data suggest that pharmacogenetic-guided dosing of warfarin is a cost-effective strategy to improve outcomes of patients with AF treated with warfarin in the United Kingdom and in Sweden.

Affiliated researcher

PubMed 27272045

DOI 10.1038/tpj.2016.41

Crossref 10.1038/tpj.2016.41

pii: tpj201641