Evidence map›Paper›PMID 28915306›Full record

ArticlePuerto Rico health sciences journal2017

Cost-Utility Study of Warfarin Genotyping in the VACHS Affiliated Anticoagulation Clinic of Puerto Rico.

Carlos Martes-Martinez, Cristian Méndez-Sepúlveda, Joel Millán-Molina, Matthew French-Kim, Heriberto Marín-Centeno, Giselle C Rivera-Miranda, José J Hernández-Muñoz, Jorge Duconge-Soler

Abstract readComparative Study
In one paragraph

Article in Puerto Rico health sciences journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Cost-effectiveness of precision medicine: a scoping review.International journal of public health · 2019
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Carlos Martes-MartinezPharmacy Practice Department, School of Pharmacy, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico.
Cristian Méndez-SepúlvedaPharmacy Practice Department, School of Pharmacy, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico.
Joel Millán-MolinaPharmacy Practice Department, School of Pharmacy, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico.
Matthew French-KimStudent at the Biology Department, University of Houston, Houston, TX.
Heriberto Marín-CentenoHealth Services Administration Department, School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
Giselle C Rivera-MirandaVA Caribbean Healthcare System (VACHS), Pharmacy Service, San Juan, Puerto Rico.
José J Hernández-MuñozPharmacy Practice Department, School of Pharmacy, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico; Pharmaceutical Sciences Department, College of Pharmacy, Texas A&M University, College Station, TX.
Jorge Duconge-SolerPharmaceutical Sciences Department, School of Pharmacy, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico.
University of Puerto Rico, Medical Sciences Campus · PRUniversity of Houston · USVA Caribbean Healthcare System · PR

Funding

A Genomic Approach to Warfarin Dose Prescription in Admixed Caribbean Hispanics.SC1HL123911 · NHLBI · UNIVERSITY OF PUERTO RICO MED SCIENCES · PI DUCONGE, JORGE · 2014 to 2017
$982k
NHLBI NIH HHS SC1 HL123911
6 · The paper itself

Abstract

objectiveTo evaluate the cost-utility of the pharmacogenetic-guided dosing of warfarin (PGx), when compared to the current dosing strategy.

methodsA Markov model was developed to assess the impact of the genotypingguided warfarin dosing in a hypothetical cohort of patients. The model was based on the percentage of time patients spent within the therapeutic international normalized ratio (INR) range (PTTR). PTTR estimates and genotype distribution were derived from a cohort of patients (n = 206) treated in the Veteran Affairs Caribbean Healthcare System (VACHS) and from results of other research study. Costs, utilities and event probability data were obtained from the literature. Probabilistic and one-way sensitivity analyses were performed to explore the range of plausible results. Willingness to pay was established at $50,000 per Quality Adjusted Life Year (QALY) gained.

resultsAccording to our model, the PGx strategy showed a QALY increase of 0.0021, with an increase in total cost of $272. This corresponds to an incremental cost-utility ratio (ICUR) of $127,501, ranging from $95,690 to $148,611. One-way sensitivity analysis revealed that the ICURs were more sensitive to the cost of genotyping and the effect of genotyping on the PTTR.

conclusionOur model suggests that the warfarin PGx was not superior to the standard of care dosing strategy in terms of cost-utility.

Indexed as

Quality-Adjusted Life YearsAnticoagulantsCost-Benefit AnalysisDose-Response Relationship, DrugGenotypeHumansInternational Normalized RatioMarkov ChainsPharmacogeneticsPuerto RicoTime FactorsVeteransWarfarinAnticoagulantsWarfarinCost-utilityPharmacogenomicsPuerto RicoWarfarin

Identifiers

PMID28915306
PMCPMC5993426
OpenAlexW2751477025

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.