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Economic analysis of pharmacogenomic-guided clopidogrel treatment in Serbian patients with myocardial infarction undergoing primary percutaneous coronary intervention
dc.creator | Mitropoulou, Christina | |
dc.creator | Fragoulakis, Vasilios | |
dc.creator | Rakićević, Ljiljana | |
dc.creator | Novković, Mirjana | |
dc.creator | Vozikis, Athanassios | |
dc.creator | Matić, Dragan M. | |
dc.creator | Antonijević, Nebojša | |
dc.creator | Radojković, Dragica | |
dc.creator | van Schaik, Ron H. | |
dc.creator | Patrinos, George P. | |
dc.date.accessioned | 2022-11-15T14:45:02Z | |
dc.date.available | 2022-11-15T14:45:02Z | |
dc.date.issued | 2016 | |
dc.identifier.issn | 1462-2416 | |
dc.identifier.uri | https://imagine.imgge.bg.ac.rs/handle/123456789/965 | |
dc.description.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. | en |
dc.publisher | Future Medicine Ltd, London | |
dc.relation | info:eu-repo/grantAgreement/MESTD/Basic Research (BR or ON)/173008/RS// | |
dc.relation | Golden Helix Foundation | |
dc.rights | restrictedAccess | |
dc.source | Pharmacogenomics | |
dc.subject | Serbian population | en |
dc.subject | pharmacogenomics | en |
dc.subject | myocardial infarction | en |
dc.subject | economic evaluation | en |
dc.subject | clopidogrel | en |
dc.title | Economic analysis of pharmacogenomic-guided clopidogrel treatment in Serbian patients with myocardial infarction undergoing primary percutaneous coronary intervention | en |
dc.type | article | |
dc.rights.license | ARR | |
dc.citation.epage | 1784 | |
dc.citation.issue | 16 | |
dc.citation.other | 17(16): 1775-1784 | |
dc.citation.rank | M22 | |
dc.citation.spage | 1775 | |
dc.citation.volume | 17 | |
dc.identifier.doi | 10.2217/pgs-2016-0052 | |
dc.identifier.scopus | 2-s2.0-84995678187 | |
dc.identifier.wos | 000391865500005 | |
dc.type.version | publishedVersion |