ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2023
Cost-effectiveness of pharmacogenomic-guided treatment for major depression.
Open access · goldAbstract read
In one paragraph
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 3 pooled it
10.2field-weighted citation impact, top 1% of its field
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.
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.
Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Economic effectiveness of pharmacogenomics-guided prescribing for psychiatric disorders: a systematic review and meta-analysis.The pharmacogenomics journal · 2026Pooled it
- Pharmacogenetic Variants and Plasma Concentrations of Antiseizure Drugs: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Evidence level for pharmacogenetic testing in antidepressant treatment: a systematic review.PharmacogenomicsPooled it
- Primary adherence to medications for the treatment of major depressive disorder: A descriptive study using real-world data.Journal of managed care & specialty pharmacy · 2026Article
- Application of escitalopram population pharmacokinetic repository: a step to precision dosing.Translational psychiatry · 2026Article
- Pharmacogenomic-guided prescribing and polypharmacy across age groups in obsessive-compulsive disorder: a retrospective study.BMC psychiatry · 2026Article
- Pharmacogenetics in Community Pharmacy: Global Perspectives and Implementation.Journal of clinical medicine · 2026Review
- The evolving landscape of pharmacogenomics: Current achievements and future directions.Pharmacological reviews · 2026Review
- Article
- Risk-managed antidepressant prescribing in primary care mental health: what pharmacogenetics can (and cannot) deliver.Frontiers in medicine · 2026Article
- Multinational cost-utility analysis of panel-based pharmacogenetics-guided treatment of patients enrolled in the U-PGx PREPARE study.EClinicalMedicine · 2026Article
- Article
- Pharmacogenetic Testing of Children and Adolescents with Mental Health Conditions: Real-World Experiences.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Using pharmacogenomics to personalise drug therapy: which drugs, when and how.Australian prescriber · 2025Review
- Polypharmacy and pharmacogenomics in high-acuity behavioral health care for autism spectrum disorder: a retrospective study.Child and adolescent psychiatry and mental health · 2025Article
- Article
- Normalising the Implementation of Pharmacogenomic (PGx) Testing in Adult Mental Health Settings: A Theory-Based Systematic Review.Journal of personalized medicine · 2024Review
- Understanding general practitioner and pharmacist preferences for pharmacogenetic testing in primary care: a discrete choice experiment.The pharmacogenomics journal · 2024Article
- Article
- Patient perspectives on pharmacogenomic (PGx) testing for antidepressant prescribing in primary care: a qualitative description study.Journal of community genetics · 2024Article
Corrections and comments
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Authors and funding
17 authors at 1 institution in 1 country.
Shahzad GhanbarianThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC shahzad.ghanbarian@ubc.ca.
Gavin W K WongThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Mary BunkaThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Louisa EdwardsThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Sonya CressmanThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Tania ConteThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Morgan PriceThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Christian SchuetzThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Linda RichesThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Ginny LandryThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
David EricksonThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Kim McGrailThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Sandra PetersonThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Rohit VijhThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Alison M HoensThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Jehannine AustinThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Stirling BryanThe Centre for Clinical Epidemiology and Evaluation (Ghanbarian, Wong, Bunka, Edwards, Cressman, Conte, Bryan), Vancouver Coastal Health Research Institute, and The School of Public and Population Health (Ghanbarian, Wong, Bunka, Edwards, Conte, Vijh, Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Cressman), Simon Fraser University, Burnaby, BC; Department of Family Practice (Price, Vijh), and Department of Physiatry (Schuetz), Faculty of Medicine, University of British Columbia, Vancouver, BC; Patient partner (Riches), Prince George, BC; Patient partner (Landry), New Westminster, BC; Psychology Department (Erickson), Fraser Health, New Westminster, BC; Centre for Health Services and Policy Research (McGrail, Peterson), and Departments of Physical Therapy (Hoens) and Medical Genetics (Austin), University of British Columbia, Vancouver, BC.
Vancouver Coastal Health · CA
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPharmacogenomic testing to identify variations in genes that influence metabolism of antidepressant medications can enhance efficacy and reduce adverse effects of pharmacotherapy for major depressive disorder. We sought to establish the cost-effectiveness of implementing pharmacogenomic testing to guide prescription of antidepressants.
methodsWe developed a discrete-time microsimulation model of care pathways for major depressive disorder in British Columbia, Canada, to evaluate the effectiveness and cost-effectiveness of pharmacogenomic testing from the public payer's perspective over 20 years. The model included unique patient characteristics (e.g., metabolizer phenotypes) and used estimates derived from systematic reviews, analyses of administrative data (2015-2020) and expert judgment. We estimated incremental costs, life-years and quality-adjusted life-years (QALYs) for a representative cohort of patients with major depressive disorder in BC.
resultsPharmacogenomic testing, if implemented in BC for adult patients with moderate-severe major depressive disorder, was predicted to save the health system $956 million ($4926 per patient) and bring health gains of 0.064 life-years and 0.381 QALYs per patient (12 436 life-years and 74 023 QALYs overall over 20 yr). These savings were mainly driven by slowing or avoiding the transition to refractory (treatment-resistant) depression. Pharmacogenomic-guided care was associated with 37% fewer patients with refractory depression over 20 years. Sensitivity analyses estimated that costs of pharmacogenomic testing would be offset within about 2 years of implementation.
interpretationPharmacogenomic testing to guide antidepressant use was estimated to yield population health gains while substantially reducing health system costs. These findings suggest that pharmacogenomic testing offers health systems an opportunity for a major value-promoting investment.
Indexed as
Major Depressive DisorderAdultAntidepressive AgentsBritish ColumbiaCost-Benefit AnalysisDepressionHumansPharmacogeneticsQuality-Adjusted Life YearsAntidepressive Agents
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