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

Lookup NU author(s): Professor Farhad Kamali


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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.

Publication metadata

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

Publication type: Article

Publication status: Published

Journal: Pharmacogenomics Journal

Year: 2016

Volume: 16

Issue: 5

Pages: 478-484

Print publication date: 01/10/2016

Online publication date: 07/06/2016

Acceptance date: 02/05/2016

ISSN (print): 1470-269X

ISSN (electronic): 1473-1150

Publisher: Nature Publishing Group


DOI: 10.1038/tpj.2016.41


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Funder referenceFunder name
Swedish Research Council (Medicine)
Clinical Research Support at Uppsala University
EU Commission
Swedish Heart and Lung Foundation
HEALTH-F2-2009-223062European Community