ArticlePCN reports : psychiatry and clinical neurosciences2025
Cost-effectiveness analysis of pharmacogenetic-guided antiseizure medication therapy based on the risk of HLA-A*31:01 allele variants in Japan.
Article in PCN reports : psychiatry and clinical neurosciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Cost-effectiveness analysis of pharmacogenetic-guided antiseizure medication therapy based on the risk of HLA-A*31:01 allele variants in Japan.PCN reports : psychiatry and clinical neurosciences · 2025Article
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Authors and funding
6 authors.
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Abstract
Aim: Carbamazepine (CBZ) remains a common antiseizure medication for focal epilepsy but carries the risk of cutaneous adverse drug reactions (cADRs), including Stevens-Johnson syndrome and toxic epidermal necrolysis. The HLA-A*31:01 allele is associated with increased risk of CBZ-induced cADRs, with notably high prevalence (8.4%) in the Japanese population. While genetic screening before CBZ treatment has proven cost-effective in other populations, its economic value in Japan remains unexplored. Methods: We conducted a cost-effectiveness analysis comparing two strategies for newly diagnosed focal epilepsy treatment: (1) screening HLA-A*31:01 before CBZ treatment, with CBZ for negative results and levetiracetam for positive results, and (2) CBZ treatment without screening. Effectiveness was measured in quality-adjusted life years (QALYs) based on utility values scored from 0 ( Results: The incremental cost-effectiveness ratio was 6956 USD/QALY, below the WTP threshold of 33,784 USD, indicating high cost-effectiveness. Probabilistic sensitivity analyses revealed that the probability of the HLA screening strategy being cost-effective was 97.0%, confirming stable cost-effectiveness. Conclusion: HLA-A*31:01 screening before CBZ treatment is cost-effective in the Japanese population. These findings support incorporating genetic screening into Japan's healthcare coverage system to enable more personalized medicine approaches in epilepsy treatment.
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