BACKGROUND: Pharmacogenetic testing can provide predictive insights about the efficacy and safety of drugs used in cancer treatment. Although many drug-gene associations have been reported in the literature, the strength of evidence supporting each association can vary significantly. Even among the subgroup of drugs classified by the PharmGKB database to have a high or moderate level of evidence, there is limited information regarding the economic value of pharmacogenetic testing.OBJECTIVES: To: (a) summarize the available pharmacoeconomic evidence assessing the value of pharmacogenetic testing for cancer drugs with clinically relevant drug-gene associations; (b) determine the quality of the studies that contain this evidence; and (c) discuss the quality of this evidence with respect to the level of evidence of the drug-gene associations. METHODS:The PharmGKB database was used to identify cancer drugs with clinically relevant drug-gene associations graded high (1A, 1B) or moderate (2A, 2B). A systematic literature review was conducted using these drugs. Ovid MEDLINE and Embase databases were searched to identify costeffectiveness, cost-utility, or cost-minimization studies comparing pharmacogenetic testing to an alternative. Cost and effect values from every relevant comparison within the studies were extracted, and the incremental cost-effectiveness ratio (ICER) was either extracted or calculated for each comparison. Quality assessment was conducted for each study using the Quality of Health Economic Studies (QHES) instrument. Qualitative synthesis was used to summarize the data.

across age, severity, race and income groups, respectively. ConClusions: Less than one-third of articles investigating heterogeneity reported extractable data to quantify heterogeneity in the reported COI. Evidence regarding heterogeneity in COI can help identify differential cost burden within and across disease settings.

The present study investigated the status of the usage of augmentative and alternative comniunication (AAC) systems in special schools for children with intellectual disabilities. Questionnaires were distributed to 81 departments of specia] schools for children with intellectual disabilities in the Tokyo metropolitan area, Replics were received from 55 in$tructors. Over 95% of the instructors responded that they used picture cards and photographs, but fewer than 50% that they used communication methods such as communication boards, communication books, unique schoolfclassroom signs, or computers. Usage of voice output communication aids (VOCA) was reported by fewer than 30% of the instructors. More than 50% of the instmctors responded that some method of communication was necessary, and over 50% that it was difficult to teach young children using computers, communication books, or Makaton signs. The frequency of usage of Makaton signs was sigriificantly lower in the high school departments, compared to the elementary scbool departments, whereas computer usage increased inversely. Based on these results, the current status and issues regarding usage of augmentative and alternative cornmunication in schools supporting children with intellectual disal)ilities was discussed.