Pharmacoeconomic evaluation of warfarin pharmacogenomics

Areas covered: Published studies on pharmacoeconomics of warfarin pharmacogenomic application are reviewed. A literature search was done using Medline and Embase covering the period 2000 -- 2010. Decision tree and Markov modeling were the most frequently used methods in the reviewed reports. Studies incorporating clinical efficacy data of genotype-guided dosing algorithm had shown that warfarin pharmacogenomics would improve quality-adjusted life-years (QALYs) gained. Nevertheless, it was unlikely to be cost-effective for general patients. Influential factors to improve the cost-effectiveness included low genotyping cost, high effectiveness in improving anticoagulation control/event rate, and applying warfarin pharmacogenomics to patients with high bleeding risk or at practice sites with suboptimal management of anticoagulation control. Expert opinion: Warfarin pharmacogenomics would improve QALYs and could possibly be cost-effective in selected patient groups or practice sites.