CYP2D6 genotyping in the daily routine of a psychiatric hospital – pharmacoeconomic evaluation
Abstract
Today, pharmacogenetic tests are commonly used to improve the efficacy and safety of antipsychotic (AP) treatment. However, the economic aspects of their implementation in the psychiatry clinic routine are not well studied.
Aim.To evaluate the pharmacoeconomic benefits of CYP2D6 polymorphisms genotyping in psychiatric patients.
Materials and methods. CYP2D6 genetic polymorphisms (*3, *4, *5, *6, *1ХN) were tested in 298 psychiatric in-patients. The mean AP daily doses and the hospital stay duration differed between poor (PM), extensive (EM) and ulta-rapid (UM) metabolizers. Based on these data, a pharmacoeconomic decision-making model was created. The model calculates direct medical costs for the patient care with and without pharmacogenetics tests.
Results. Pharmacogenetics tests (CYP2D6 genotyping) performed prior to the antipsychotic therapy were shown to be a cost-effective strategy as it gives additional clinical and pharmacological information, optimize the duration of AP treatment, and results in a lower direct medical cost of in-patient care. The cost of genotyping is less than 1% of the total direct medical costs. This strategy remains cost-effective even if the genotyping costs more than 3893.8 RUB (199% of the current value) and also if the differences in the hospital stay durations between PM, EM and UM are not less than 5 days.
About the Authors
A. A. Kurylev
P. P. Kashchenko Psychiatric hospital №1
Pavlov First Sankt-Peterburg State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
10 Menkovskaya Str., Nikolskoe 190005, Gatchinsky District, Leningrad Region, Russia
6-8 L'va Tolstogo Str., Sankt-Peterburg 197022, Russia
MD, Assistant at the Chair of clinical pharmacology and evidence-based medicine, Pavlov First Saint Petersburg State Medical University
B. V. Andreev
P. P. Kashchenko Psychiatric hospital №1
Sankt-Peterburg State University
Russian Federation
Russian Federation
10 Menkovskaya Str., Nikolskoe 190005, Gatchinsky District, Leningrad Region, Russia
7-9 Universitetskaya Emb., Sankt-Peterburg 199034, Russia
MD, Professor & Chair, Department of pharmacology of St. Petersburg State University; Clinical pharmacologist, P. P. Kashchenko Psychiatric Hospital №1; St. Petersburg, Russia
A. S. Kolbin
Pavlov First Sankt-Peterburg State Medical University, Health Ministry of Russian Federation
Sankt-Peterburg State University
Russian Federation
Russian Federation
6-8 L'va Tolstogo Str., Sankt-Peterburg 197022, Russia
7-9 Universitetskaya Emb., Sankt-Peterburg 199034, Russia
MD, Professor & Chair, Department of clinical pharmacology and evidence-based medicine, Pavlov First Saint Petersburg State Medical University; Professor at the Department of Pharmacology of St. Petersburg State University. Tel.: 8(812)338 66 85
O. V. Limankin
P. P. Kashchenko Psychiatric hospital №1
Russian Federation
Russian Federation
10 Menkovskaya Str., Nikolskoe 190005, Gatchinsky District, Leningrad Region, Russia
MD, Director of the P. P. Kashchenko Psychiatric Hospital №1, St.Petersburg, Russia
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Review
For citations:
Kurylev A.A., Andreev B.V., Kolbin A.S., Limankin O.V. CYP2D6 genotyping in the daily routine of a psychiatric hospital – pharmacoeconomic evaluation. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2018;11(1):19-26. (In Russ.) https://doi.org/10.17749/2070-4909.2018.11.1.019-026
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