@article{3164338,
    title = "Economic evaluation of pharmacogenomic-guided warfarin treatment for
elderly Croatian atrial fibrillation patients with ischemic stroke",
    author = "Mitropoulou, Christina and Fragoulakis, Vasilios and Bozina, Nada and and Vozikis, Athanassios and Supe, Svjetlana and Bozina, Tamara and and Poljakovic, Zdravka and van Schaik, Ron H. and Patrinos, George P.",
    journal = "Current Pharmacogenomics",
    year = "2015",
    volume = "16",
    number = "2",
    pages = "137-148",
    publisher = "Future Medicine Ltd",
    issn = "1570-1603",
    doi = "10.2217/pgs.14.167",
    keywords = "atrial fibrillation; cost-effectiveness analysis; ischemic stroke;
pharmacogenomics economic evaluation; warfarin",
    abstract = "Background & methods: Economic evaluation in genomic medicine is an
emerging discipline to assess the cost-effectiveness of genome-guided
treatment. Here, we developed a pharmaco-economic model to assess
whether pharmacogenomic (PGx)-guided warfarin treatment of elderly
ischemic stroke patients with atrial fibrillation in Croatia is cost
effective compared with non-PGx therapy. The time horizon of the model
was set at 1 year. Results: Our primary analysis indicates that 97.07%
(95% CI: 94.08-99.34%) of patients belonging to the PGx-guided group
have not had any major complications, compared with the control group
(89.12%; 95% CI: 84.00-93.87%, p < 0.05). The total cost per patient
was estimated at Euro538.7 (95% CI: Euro526.3-551.2) for the PGx-guided
group versus Euro219.7 (95% CI: Euro137.9-304.2) for the control group.
In terms of quality-adjusted life-years (QALYs) gained, total QALYs was
estimated at 0.954 (95% CI: 0.943-0.964) and 0.944 (95% CI:
0.931-0.956) for the PGx-guided and the control groups, respectively.
The true difference in QALYs was estimated at 0.01 (95% CI:
0.005-0.015) in favor of the PGx-guided group. The incremental
cost-effectiveness ratio of the PGx-guided versus the control groups was
estimated at Euro31,225/QALY. Conclusion: Overall, our data indicate
that PGx-guided warfarin treatment may represent a cost-effective
therapy option for the management of elderly patients with atrial
fibrillation who developed ischemic stroke in Croatia. Original
submitted 4 June 2014; Revision submitted 12 November 2014"
}