Economic Evaluation of Pharmacogenetic Tests in Patients Subjected to Renal Transplantation: A Review of Literature

Abstract

Renal transplantation is the treatment of choice for the patients with end-stage renal failure. Genetic factors, among others, can influence variability in response to immunosuppressive drugs. Nowadays, due to restrictive health resources, the question arises whether routine pharmacogenetic analyses should be done in the renal transplant recipients or not. The aim of this literature review was to present the up-to-date information considering the economic feasibility of pharmacogenetic testing in patients subjected to renal transplantation. The organization United Network for Organ Sharing in the US estimated that total costs per renal transplant concerning these analyses were $334,300 in 2014. Pharmacogenetic testing prior to treatment initiation could be helpful to predict and assess treatment response and the risks for adverse drug reactions. This kind of testing before treatment initiation seems to be one of the most promising applications of pharmacokinetics. Although pharmacogenetic tests were found to be a cost-effective or cost-saving strategy in many cases, some authors represent another opinion. However, if the real costs of renal transplantation are recognized, the application of these tests in the standard daily practice could be considered more realistic, which additionally emphasizes the importance of future studies assessing their cost effectiveness.

Deceased donor kidney allocation: an economic evaluation of contemporary longevity matching practices

“…Factors that improve the survival of a low-quality graft, could change the cost-effectiveness results of different allocation options discussed in the paper. Novel immunosuppressive drugs have the potential to improve graft survival significantly [47]. Furthermore, factors such as warm ischaemia time [48], recipient factors such as EPTS score, level of allosensitization and the cause of renal failure, and donor factors such as age, cause of death, donation after cardiac death, terminal creatinine have been found to be associated with the cost of kidney transplantation.…”

Deceased donor kidney allocation: an economic evaluation of contemporary longevity matching practices

“…Novel immunosuppressive drugs have the potential to improve graft survival signi cantly (47) . Furthermore, factors such as warm ischaemia time (48) , recipient factors such as EPTS score, level of allosensitization and the cause of renal failure, and donor factors such as age, cause of death, donation after cardiac death, terminal creatinine have been found to be associated with the cost of kidney transplantation.…”

Past, present and future perspectives of therapeutic drug monitoring in India

“…Hence, prospective studies must be performed to determine its efficacy and cost-effectiveness in optimising pharmacotherapy and reducing drug toxicity in drugs through pharmacogenomics-oriented TDM, where the pharmacokinetics is influenced by genetic polymorphisms. 83…”