DOI: https://doi.org/10.14710/jmki.12.3.2024.252-265

ECONOMIC EVALUATION OF PHARMACOGENETIC-GUIDED PRESCRIBING IN PRECISION MEDICINE FOR CARDIOVASCULAR DISEASES: AN EVIDENCE SYNTHESIS FROM ASIAN COUNTRIES

*Via Dolorosa Halilintar  -  School of Public Health, University of Indonesia, Indonesia
Lonah Lonah  -  School of Medicine and Health Sciences, Universitas Katolik Indonesia Atma Jaya, Indonesia
Pujiyanto Pujiyanto  -  School of Public Health, University of Indonesia, Indonesia

Citation Format:
Abstract

Precision medicine, particularly pharmacogenetic-guided approaches, has emerged as a promising tool to optimize treatment strategies for cardiovascular disease. However, the economic evaluation of these approaches in Asian populations remains underexplored. This review study aimed to synthesize evidence on the implementation, methodology, research gaps, and limitations of pharmacogenetic-guided precision medicine in cardiovascular disease among the Asian population. A comprehensive search of electronic databases (Pubmed, Embase, Google Scholar and Cochrane Library) was conducted to identify relevant studies. The data were extracted and synthesized to address the study objectives A total of 12 studies were included in the analysis. Economic evaluation studies of pharmacogenetic-guided precision medicine in cardiovascular disease management in Asian countries are still limited, with precision medicine interventions often requiring high resources. The sampling process remains a challenge in conducting economic evaluation studies, and there are limitations in obtaining clinical outcome descriptions from real-world evidence, as most studies rely on literature reviews or modeling-based approaches. Furthermore, most studies use a provider or healthcare cost perspective, limiting the comprehensiveness of cost information. This evidence synthesis highlights the potential for pharmacogenetic-guided precision medicine in cardiovascular disease management among the Asian population, as well as the current challenges and limitations in conducting economic evaluations. Further research is needed to address these issues, develop more robust sampling strategies, obtain real-world clinical outcome data, and provide comprehensive cost information to inform clinical practice and healthcare policy in the region.

Fulltext View|Download
Keywords: Precision medicine, Pharmacogenetics, Cardiovascular disease, Economic evaluation, Asian population

Article Metrics:

Article Info
Section: Articles
Language : EN
Recent articles
PENDIDIKAN DAN PELATIHAN PEGAWAI SEBAGAI FAKTOR KUNCI KEBERHASILAN PENERAPAN TOTAL QUALITY MANAGEMENT (TQM) DALAM PENCAPAIAN INDIKATOR NASIONAL MUTU (INM) DI RSGMP X TANTANGAN INTEROPERABILITAS REKAM MEDIS : STUDI KASUS DI RUMAH SAKIT SINGAPARNA MEDIKA CITRAUTAMA QUALITY OF CARE AND TREATMENT ON EMERGENT THREATS FOR MATERNAL AND NEWBORN More recent articles
Most cited articles
Analisis Pengelolaan Obat Pasien BPJS Di Instalasi Farmasi Rumah Sakit Panti Wilasa Citarum Semarang Remaja Sebagai Penggerak Utama dalam Implementasi Program Kesehatan Remaja Pelaksanaan Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) Ditinjau dari Aspek Bidan Desa sebagai Pelaksana di Kabupaten Jepara Evaluasi Sistem Informasi Manajemen Puskesmas Guna Mendukung Penerapan Sikda Generik Menggunakan Metode Hot Fit Di Kabupaten Purworejo Analisis Pelaksanaan Program Kemitraan Bidan dan Dukun Ditinjau Dari Aspek Input, Proses dan Output di Wilayah Dinas Kesehatan Kabupaten Fakfak Provinsi Papua Barat More cited articles
  1. AlMukdad, Sawsan, Hazem Elewa, Salaheddin Arafa, and Daoud Al-Badriyeh. 2021. “Short- and Long-Term Cost-Effectiveness Analysis of CYP2C19 Genotype-Guided Therapy, Universal Clopidogrel, versus Universal Ticagrelor in Post-Percutaneous Coronary Intervention Patients in Qatar.” International Journal of Cardiology 331: 27–34. https://doi.org/10.1016/j.ijcard.2021.01.044
  2. Berm, Elizabeth J.J. et al. 2016. “Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature.” PLoS ONE 11(1): 1–22
  3. Bylstra, Yasmin et al. 2019. “Implementation of Genomics in Medical Practice to Deliver Precision Medicine for an Asian Population.” npj Genomic Medicine 4(1). http://dx.doi.org/10.1038/s41525-019-0085-8
  4. Cai, Zeling et al. 2021. “Cost-Effectiveness of CYP2C19 Genotyping to Guide Antiplatelet Therapy for Acute Minor Stroke and High-Risk Transient Ischemic Attack.” Scientific Reports 11(1): 1–10
  5. Chen, Wenjia et al. 2022. “Assessing the Cost-Effectiveness of Precision Medicine: Protocol for a Systematic Review and Meta-Analysis.” BMJ Open 12(4): 1–7
  6. Chong, Huey Yi et al. 2014. “Cost-Effectiveness Analysis of Pharmacogenetic-Guided Warfarin Dosing in Thailand.” Thrombosis Research 134(6): 1278–84. http://dx.doi.org/10.1016/j.thromres.2014.10.006
  7. Chung, Brian, Brooke Willis, and Poh San Lai. 2019. “Development of Clinical Genetics in Asia.” American Journal of Medical Genetics, Part C: Seminars in Medical Genetics 181(2): 150–54
  8. Duarte, Julio D., and Larisa H. Cavallari. 2021. 18 Nature Reviews Cardiology Pharmacogenetics to Guide Cardiovascular Drug Therapy
  9. Eljilany, Islam, Hazem Elewa, and Daoud Al-Badriyeh. 2022. “Cost-Benefit Analysis of Genotype-Guided Interruption Days in Warfarin Pre-Procedural Management.” Current Problems in Cardiology: 101128. https://doi.org/10.1016/j.cpcardiol.2022.101128
  10. Husereau, Don et al. 2022. “Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) Statement: Updated Reporting Guidance for Health Economic Evaluations.” Clinical Therapeutics 44(2): 158–68
  11. Jiang, Minghuan, and Joyce H.S. You. 2017. “CYP2C19 LOF and GOF-Guided Antiplatelet Therapy in Patients with Acute Coronary Syndrome: A Cost-Effectiveness Analysis.” Cardiovascular Drugs and Therapy 31(1): 39–49
  12. Jittikoon, Jiraphun et al. 2020. “Economic Impact of Medical Genetic Testing on Clinical Applications in Thailand.” PLoS ONE 15(12 December): 1–13. http://dx.doi.org/10.1371/journal.pone.0243934
  13. Kaló, Zoltán et al. 2013. “Capacity Building for HTA Implementation in Middle-Income Countries: The Case of Hungary.” Value in Health Regional Issues 2(2): 264–66. http://dx.doi.org/10.1016/j.vhri.2013.06.002
  14. Kamil, Ahmad Amir et al. 2022. “Genetic-Guided Pharmacotherapy for Atrial Fibrillation: A Systematic and Critical Review of Economic Evaluations.” Value in Health 25(3): 461–72. https://doi.org/10.1016/j.jval.2021.09.013
  15. Kim, Dong Jin et al. 2017. “Cost Effectiveness of Genotype-Guided Warfarin Dosing in Patients with Mechanical Heart Valve Replacement Under the Fee-for-Service System.” Applied Health Economics and Health Policy 15(5): 657–67
  16. Kim, Ji Heon, Doreen Su Yin Tan, and Mark Yan Yee Chan. 2021. “Cost-Effectiveness of CYP2C19-Guided Antiplatelet Therapy for Acute Coronary Syndromes in Singapore.” Pharmacogenomics Journal 21(2): 243–50. http://dx.doi.org/10.1038/s41397-020-00204-6
  17. Kow, Chia Siang, Abdullah Faiz Zaihan, and Syed Shahzad Hasan. 2021. “CYP2C19 Genotype-Guided Antiplatelet Therapy Among Asian Patients with Ischaemic Stroke.” Clinical Drug Investigation 41(1): 115–16
  18. Lo, Cody et al. 2020. “Pharmacogenomics in Asian Subpopulations and Impacts on Commonly Prescribed Medications.” Clinical and Translational Science 13(5): 861–70
  19. Mahayri, Al et al. 2022. “Pharmacogenomics Implementation in Cardiovascular Disease in a Highly Diverse Population : Initial Findings and Lessons Learned from a Pilot Study in United Arab Emirates.” Human Genomics 16(42): 1–12
  20. Mangham-Jefferies, Lindsay et al. 2015. “Cost-Effectiveness of Strategies to Improve the Utilization and Provision of Maternal and Newborn Health Care in Low-Income and Lower-Middle-Income Countries: A Systematic Review [BMC Pregnancy and Childbirth 14, (2014) 243].” BMC Pregnancy and Childbirth 15(1)
  21. Mboi, Nafsiah et al. 2018. “Articles On the Road to Universal Health Care in Indonesia , 1990 – 2016 : A Systematic Analysis for the Global Burden of Disease Study.” The Lancet 6736(18): 1–11. http://dx.doi.org/10.1016/S0140-6736(18)30595-6
  22. Mendoza, Walter, and J.Jaime Miranda. 2018. “Global Shifts in Cardiovascular Disease, the Epidemiologic Transition and Other Contributing Factors: Towards a New Practice of Global Health Cardiology.” Cardiology Clinical 14(4): 535–62. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958625/pdf/nihms960157.pdf
  23. Narasimhalu, Kaavya et al. 2020. “Cost Effectiveness of Genotype-Guided Antiplatelet Therapy in Asian Ischemic Stroke Patients: Ticagrelor as an Alternative to Clopidogrel in Patients with CYP2C19 Loss of Function Mutations.” Clinical Drug Investigation 40(11): 1063–70
  24. Ng, Siok Shen, Surakit Nathisuwan, Arintaya Phrommintikul, and Nathorn Chaiyakunapruk. 2020. “Cost-Effectiveness of Warfarin Care Bundles and Novel Oral Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation in Thailand.” Thrombosis Research 185: 63–71. https://doi.org/10.1016/j.thromres.2019.11.012
  25. Noyes, James D. et al. 2017. “Precision Medicine and Adverse Drug Reactions Related to Cardiovascular Drugs.” Disease (MDPI) 47(11): 63
  26. Sethi, Yashendra et al. 2023. “Precision Medicine and the Future of Cardiovascular Diseases : A Clinically Oriented Comprehensive Review.” : 1–31
  27. Stergiopoulos, Kathleen, and David L. Brown. 2014. “Genotype-Guided vs Clinical Dosing Ofwarfarin and Its Analogues: Meta-Analysis of Randomized Clinical Trials.” JAMA Internal Medicine 174(8): 1330–38
  28. Tomlinson, Brian, Paul Chan, and Zhong-min Liu. 2020. “Statin Intolerance — An Asian Perspective.” Journal of Atherosclerosis & Thrombolytic 27(111): 485–88
  29. Wang, Y., B. P. Yan, D. Liew, and V. W.Y. Lee. 2018. “Cost-Effectiveness of Cytochrome P450 2C19 ∗2 Genotype-Guided Selection of Clopidogrel or Ticagrelor in Chinese Patients with Acute Coronary Syndrome.” Pharmacogenomics Journal 18(1): 113–20. http://dx.doi.org/10.1038/tpj.2016.94
  30. World Health Organization. 2021. World Health Organization Institutionalizing Health Technology Assessment Mechanisms: A How to Guide. https://apps.who.int/iris/bitstream/handle/10665/340722/9789240020665-eng.pdf?sequence=1
  31. You, Joyce H.S. 2014. “Pharmacogenetic-Guided Selection of Warfarin versus Novel Oral Anticoagulants for Stroke Prevention in Patients with Atrial Fibrillation: A Cost-Effectiveness Analysis.” Pharmacogenetics and Genomics 24(1): 6–14
  32. Zhao, Dong. 2021. “Epidemiological Features of Cardiovascular Disease in Asia.” JACC: Asia 1(1): 1–13. https://doi.org/10.1016/j.jacasi.2021.04.007
  33. Zheng, Lukai, Chunsong Yang, Lingbao Xiang, and Zilong Hao. 2019. “Genotype-Guided Antiplatelet Therapy Compared with Conventional Therapy for Patients with Acute Coronary Syndromes: A Systematic Review and Meta-Analysis.” Biomarkers 24(6): 517–23. https://doi.org/10.1080/1354750X.2019.1634764
  34. Zhong, Zhixiong et al. 2017. “Analysis of CYP2C19 Genetic Polymorphism in a Large Ethnic Hakka Population in Southern China.” Medical Science Monitor 23: 6186–92
  35. Zhu, Ye et al. 2020. “Systematic Review of the Evidence on the Cost-Effectiveness of Pharmacogenomics-Guided Treatment for Cardiovascular Diseases.” Genetics in Medicine 22(3): 475–86

Last update:

No citation recorded.

Last update: 2024-12-26 17:09:34

No citation recorded.