TY  - JOUR
AU  - Mitropoulou, Christina
AU  - Fragoulakis, Vasilios
AU  - Rakićević, Ljiljana
AU  - Novković, Mirjana
AU  - Vozikis, Athanassios
AU  - Matić, Dragan M.
AU  - Antonijević, Nebojša
AU  - Radojković, Dragica 
AU  - van Schaik, Ron H.
AU  - Patrinos, George P.
PY  - 2016
UR  - https://imagine.imgge.bg.ac.rs/handle/123456789/965
AB  - Introduction: Clopidogrel, which is activated by the CYP2C19 enzyme, is among the drugs for which all major regulatory agencies recommend genetic testing to be performed to identify a patient's CYP2C19 genotype in order to determine the optimal antiplatelet therapeutic scheme. The CYP2C19*2 and CYP2C19*3 variants are loss-of-function alleles, leading to abolished CYP2C19 function and thus have the risk of thrombotic events for carriers of these alleles on standard dosages, while the CYP2C19*17 allele results in CYP2C19 hyperactivity. Aims: Here, we report our findings from a retrospective study to assess whether genotyping for the CYP2C19*2 allele was cost effective for myocardial infarction patients receiving clopidogrel treatment in the Serbian population compared with the nongenotype-guided treatment. Results: We found that 59.3% of the CYP2C19*1/*1 patients had a minor or major bleeding event versus 42.85% of the CYP2C19*1/*2 and *2/*2, while a reinfarction event occurred only in 2.3% of the CYP21C9*1/*1 patients, compared with 11.2% of the CYP2C19*1/*2 and CYP2C19*2/*2 patients. There were subtle differences between the two patient groups, as far as the duration of hospitalization and rehabilitation is concerned, in favor of the CYP2C19*1/*1 group. The mean cost for the CYP2C19*1/*1 patients was estimated at (sic)2547 versus (sic)2799 in the CYP2C19*1/*2 and CYP2C19*2/*2 patients. Furthermore, based on the overall CYP2C19*1/*2 genotype frequencies in the Serbian population, a break-even point analysis indicated that performing the genetic test prior to drug prescription represents a cost-saving option, saving (sic)13 per person on average. Conclusion: Overall, our data demonstrate that pharmacogenomics-guided clopidogrel treatment may represent a cost-saving approach for the management of myocardial infarction patients undergoing primary percutaneous coronary intervention in Serbia.
PB  - Future Medicine Ltd, London
T2  - Pharmacogenomics
T1  - Economic analysis of pharmacogenomic-guided clopidogrel treatment in Serbian patients with myocardial infarction undergoing primary percutaneous coronary intervention
EP  - 1784
IS  - 16
SP  - 1775
VL  - 17
DO  - 10.2217/pgs-2016-0052
ER  - 

@article{
author = "Mitropoulou, Christina and Fragoulakis, Vasilios and Rakićević, Ljiljana and Novković, Mirjana and Vozikis, Athanassios and Matić, Dragan M. and Antonijević, Nebojša and Radojković, Dragica  and van Schaik, Ron H. and Patrinos, George P.",
year = "2016",
abstract = "Introduction: Clopidogrel, which is activated by the CYP2C19 enzyme, is among the drugs for which all major regulatory agencies recommend genetic testing to be performed to identify a patient's CYP2C19 genotype in order to determine the optimal antiplatelet therapeutic scheme. The CYP2C19*2 and CYP2C19*3 variants are loss-of-function alleles, leading to abolished CYP2C19 function and thus have the risk of thrombotic events for carriers of these alleles on standard dosages, while the CYP2C19*17 allele results in CYP2C19 hyperactivity. Aims: Here, we report our findings from a retrospective study to assess whether genotyping for the CYP2C19*2 allele was cost effective for myocardial infarction patients receiving clopidogrel treatment in the Serbian population compared with the nongenotype-guided treatment. Results: We found that 59.3% of the CYP2C19*1/*1 patients had a minor or major bleeding event versus 42.85% of the CYP2C19*1/*2 and *2/*2, while a reinfarction event occurred only in 2.3% of the CYP21C9*1/*1 patients, compared with 11.2% of the CYP2C19*1/*2 and CYP2C19*2/*2 patients. There were subtle differences between the two patient groups, as far as the duration of hospitalization and rehabilitation is concerned, in favor of the CYP2C19*1/*1 group. The mean cost for the CYP2C19*1/*1 patients was estimated at (sic)2547 versus (sic)2799 in the CYP2C19*1/*2 and CYP2C19*2/*2 patients. Furthermore, based on the overall CYP2C19*1/*2 genotype frequencies in the Serbian population, a break-even point analysis indicated that performing the genetic test prior to drug prescription represents a cost-saving option, saving (sic)13 per person on average. Conclusion: Overall, our data demonstrate that pharmacogenomics-guided clopidogrel treatment may represent a cost-saving approach for the management of myocardial infarction patients undergoing primary percutaneous coronary intervention in Serbia.",
publisher = "Future Medicine Ltd, London",
journal = "Pharmacogenomics",
title = "Economic analysis of pharmacogenomic-guided clopidogrel treatment in Serbian patients with myocardial infarction undergoing primary percutaneous coronary intervention",
pages = "1784-1775",
number = "16",
volume = "17",
doi = "10.2217/pgs-2016-0052"
}

Mitropoulou, C., Fragoulakis, V., Rakićević, L., Novković, M., Vozikis, A., Matić, D. M., Antonijević, N., Radojković, D., van Schaik, R. H.,& Patrinos, G. P.. (2016). Economic analysis of pharmacogenomic-guided clopidogrel treatment in Serbian patients with myocardial infarction undergoing primary percutaneous coronary intervention. in Pharmacogenomics
Future Medicine Ltd, London., 17(16), 1775-1784.
https://doi.org/10.2217/pgs-2016-0052

Mitropoulou C, Fragoulakis V, Rakićević L, Novković M, Vozikis A, Matić DM, Antonijević N, Radojković D, van Schaik RH, Patrinos GP. Economic analysis of pharmacogenomic-guided clopidogrel treatment in Serbian patients with myocardial infarction undergoing primary percutaneous coronary intervention. in Pharmacogenomics. 2016;17(16):1775-1784.
doi:10.2217/pgs-2016-0052 .

Mitropoulou, Christina, Fragoulakis, Vasilios, Rakićević, Ljiljana, Novković, Mirjana, Vozikis, Athanassios, Matić, Dragan M., Antonijević, Nebojša, Radojković, Dragica , van Schaik, Ron H., Patrinos, George P., "Economic analysis of pharmacogenomic-guided clopidogrel treatment in Serbian patients with myocardial infarction undergoing primary percutaneous coronary intervention" in Pharmacogenomics, 17, no. 16 (2016):1775-1784,
https://doi.org/10.2217/pgs-2016-0052 . .