Economic Analysis of Thrombo inCode, a Clinical-Genetic Function for Assessing the Risk of Venous Thromboembolism
Rubio-Terrés, Carlos (Health Value (Madrid))
Soria Fernández, José Manuel (Institut d'Investigació Biomèdica Sant Pau)
Morange, Pierre-Emmanuel (Aix-Marseille Université)
Souto, Joan Carles (Institut d'Investigació Biomèdica Sant Pau)
Suchon, P. (Université Pierre et Marie Curie)
Mateo, José (Institut d'Investigació Biomèdica Sant Pau)
Saut, N. (Université Pierre et Marie Curie)
Rubio-Rodríguez, D. (Health Value (Madrid))
Sala, J. (Ferrer inCode (Barcelona))
Gracia, A. (Ferrer inCode (Barcelona))
Pich, S. (Gendiag.exe (Barcelona))
Salas, E. (Gendiag.exe (Barcelona))
Universitat Autònoma de Barcelona

Data:	2015
Resum:	Background: Patients with venous thromboembolism (VTE) commonly have an underlying genetic predisposition. However, genetic tests nowadays in use have very low sensitivity for identifying subjects at risk of VTE. Thrombo inCode is a new genetic tool that has demonstrated very good sensitivity, thanks to very good coverage of the genetic variants that modify the function of the coagulation pathway. Objective: To conduct an economic analysis of risk assessment of VTE from the perspective of the Spanish National Health System with Thrombo inCode (a clinical-genetic function for assessing the risk of VTE) versus the conventional/standard method used to date (factor V Leiden and prothrombin G20210A). Methods: An economic model was created from the National Health System perspective, using a decision tree in patients aged 45 years with a life expectancy of 81 years. The predictive capacity of VTE, based on identification of thrombophilia using Thrombo inCode and using the standard method, was obtained from two case-control studies conducted in two different populations (S. PAU and MARTHA; 1,451 patients in all). Although this is not always the case, patients who were identified as suffering from thrombophilia were subject to preventive treatment of VTE with warfarin, leading to a reduction in the number of VTE events and an increased risk of severe bleeding. The health state utilities (quality-adjusted life-years [QALYs]) and costs (in 2013 EUR values) were obtained from the literature and Spanish sources. Results: On the basis of a price of EUR 180 for Thrombo inCode, this would be the dominant option (more effective and with lower costs than the standard method) in both populations. The Monte Carlo probabilistic analyses indicate that the dominance would occur in 100 % of the simulations in both populations. The threshold price of Thrombo inCode needed to reach the incremental cost-effectiveness ratio (ICER) generally accepted in Spain (EUR 30,000 per QALY gained) would be between EUR 3,950 (in the MARTHA population) and EUR 11,993 (in the S. PAU population). Conclusion: According to the economic model, Thrombo inCode is the dominant option in assessing the risk of VTE, compared with the standard method currently used.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Adult ; Aged ; Aged, 80 and over ; Cost-Benefit Analysis ; Decision Trees ; Female ; Genetic Predisposition to Disease ; Genetic Testing ; Humans ; Male ; Middle Aged ; Models, Economic ; Predictive Value of Tests ; Risk Assessment ; Sensitivity and Specificity ; Spain ; Venous Thromboembolism
Publicat a:	Applied Health Economics and Health Policy, Vol. 13 Núm. 2 (january 2015) , p. 233-242, ISSN 1179-1896

DOI: 10.1007/s40258-015-0153-x
PMID: 25652150

10 p, 472.9 KB

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