title: Economic analysis of thrombo inCode, a clinical-genetic function for assessing the risk of venous thromboembolism.
abstract: BACKGROUND
  Patients with venous thromboembolism (VTE) commonly have an underlying genetic predisposition. However, genetic tests nowadays in use have very low sensitivity for identifying subjects at risk of VTE. Thrombo inCode(®) is a new genetic tool that has demonstrated very good sensitivity, thanks to very good coverage of the genetic variants that modify the function of the coagulation pathway.
  
  
  OBJECTIVE
  To conduct an economic analysis of risk assessment of VTE from the perspective of the Spanish National Health System with Thrombo inCode(®) (a clinical-genetic function for assessing the risk of VTE) versus the conventional/standard method used to date (factor V Leiden and prothrombin G20210A).
  
  
  METHODS
  An economic model was created from the National Health System perspective, using a decision tree in patients aged 45 years with a life expectancy of 81 years. The predictive capacity of VTE, based on identification of thrombophilia using Thrombo inCode(®) and using the standard method, was obtained from two case-control studies conducted in two different populations (S. PAU and MARTHA; 1,451 patients in all). Although this is not always the case, patients who were identified as suffering from thrombophilia were subject to preventive treatment of VTE with warfarin, leading to a reduction in the number of VTE events and an increased risk of severe bleeding. The health state utilities (quality-adjusted life-years [QALYs]) and costs (in 2013 EUR values) were obtained from the literature and Spanish sources.
  
  
  RESULTS
  On the basis of a price of EUR 180 for Thrombo inCode(®), this would be the dominant option (more effective and with lower costs than the standard method) in both populations. The Monte Carlo probabilistic analyses indicate that the dominance would occur in 100 % of the simulations in both populations. The threshold price of Thrombo inCode(®) needed to reach the incremental cost-effectiveness ratio (ICER) generally accepted in Spain (EUR 30,000 per QALY gained) would be between EUR 3,950 (in the MARTHA population) and EUR 11,993 (in the S. PAU population).
  
  
  CONCLUSIONS
  According to the economic model, Thrombo inCode(®) is the dominant option in assessing the risk of VTE, compared with the standard method currently used.
authors: Health Value, C/-Virgen de Aránzazu, 21, 5°B, 28034, Madrid, Spain.
authors: C
authors: C
authors: Rubio-Terrés
authors: J M
authors: JM
authors: Soria
authors: P E
authors: PE
authors: Morange
authors: J C
authors: JC
authors: Souto
authors: P
authors: P
authors: Suchon
authors: J
authors: J
authors: Mateo
authors: N
authors: N
authors: Saut
authors: D
authors: D
authors: Rubio-Rodríguez
authors: J
authors: J
authors: Sala
authors: A
authors: A
authors: Gracia
authors: S
authors: S
authors: Pich
authors: E
authors: E
authors: Salas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000191:economics* / Q000379:methods; D012680:Sensitivity and Specificity; D013030:Spain; D054556:Venous Thromboembolism / Q000191:economics* / Q000209:etiology / Q000235:genetics*
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