CMAJ

Is pharmacogenomic testing to guide antidepressant use cost effective?

December 1, 2023

In this study, researchers developed a discrete-time microsimulation model of care pathway to evaluate the effectiveness and cost-effectiveness of pharmacogenetic testing to guide antidepressant use and found that it yielded population health gains while substantially reducing health system costs. These findings suggest that pharmacogenomic testing offers health systems an opportunity for a major value-promoting investment.

• This discrete-time microsimulation model of care pathways for major depressive disorder in British Columbia (BC), Canada looked at the cost-effectiveness of pharmacogenomic testing from the public payer's perspective over 20 years.
• Pharmacogenomic testing, if implemented in BC for adult patients with moderate-severe major depressive disorder, was predicted to save the health system $956 million ($4,926 per patient) and bring health gains of 0.064 life-years and 0.381 quality-adjusted life-years (QALYs) per patient (12,436 life-years and 74,023 QALYs overall over 20 years). These savings were mainly driven by slowing or avoiding the transition to refractory (treatment-resistant) depression.
• Pharmacogenomic-guided care was associated with 37% fewer patients with refractory depression over 20 years.
• Sensitivity analyses estimated that costs of pharmacogenomic testing would be offset within about 2 years of implementation.

Source:

Ghanbarian S, et al. (2023, November 14). CMAJ. Cost-effectiveness of pharmacogenomic-guided treatment for major depression. https://pubmed.ncbi.nlm.nih.gov/37963621/