ArticleACR open rheumatology2025
An Updated Economic Evaluation of HLA-B*58:01 Genotype Testing in Gouty Patients for Preventing Severe Allopurinol Hypersensitivity in Thailand.
Article in ACR open rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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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.
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Who cites it
5 citing papers in PubMed.
- Financing and health system capacity for precision medicine in Asia: a six country landscape analysis.Health affairs scholar · 2026Review
- Gout: a practical approach to diagnosis and management in low- and middle-income countries and resource-limited settings.Clinical rheumatology · 2026Review
- Development of a non-genetic risk prediction model for allopurinol-induced severe cutaneous adverse drug reactions: a multicenter retrospective observational study.Clinical rheumatology · 2026Observational
- External Quality Assessment of Molecular Testing forDiagnostics (Basel, Switzerland) · 2026Article
- Assessing willingness to pay for HLA-B*58:01 genetic testing before allopurinol initiation and its potential impact on future health policy, Thailand.Scientific reports · 2026Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
objectiveHuman Leukocyte Antigen (HLA), specifically HLA-B*58:01, testing before allopurinol initiation in patients with gout in Thailand was previously shown to be cost-effective. However, several drugs are available in the treatment of gout in Thailand, so the updated cost-effectiveness analysis is warranted. This study aimed to update the cost-effectiveness of HLA-B*58:01 testing before allopurinol initiation in patients with gout in Thailand.
methodsA hybrid model consisting of a decision tree and a Markov model with a lifetime horizon from a societal perspective was undertaken. The HLA-B*58:01 testing was compared to the standard of care as no testing. Total health care costs and quality-adjusted life years (QALYs) were assessed. A comprehensive literature review along with retrospective data analysis and prospective data collection were conducted to determine inputs to inform the model. The incremental cost-effectiveness ratio analysis was calculated.
resultsHLA-B*58:01 testing could avoid 1.554 Stevens-Johnson syndrome and toxic epidermal necrosis cases, resulting in a saving of 0.140 patients' lives per 1,000 patients. It could gain 0.002 life-years and 0.004 QALYs compared to no testing. However, it required a higher lifetime cost of 4,690 Thai baht (THB), resulting in an incremental cost-effectiveness ratio of 1,093,068 THB/QALY (31,404 US dollars per QALY).
conclusionHLA-B*58:01 testing was not cost-effective before allopurinol initiation in Thai patients with gout at the current price of 1,000 THB per test. However, HLA-B*58:01 testing would be cost-effective if only probenecid was the alternative treatment for patients with positive HLA-B*58:01 results. This result would be useful for health authorities, policy decision-makers, and physicians' organizations in providing the recommendation for HLA-B*58:01 testing before initiation of allopurinol.
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Registered trials
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