title: Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature.
abstract: OBJECTIVE
  Due to extended application of pharmacogenetic and pharmacogenomic screening (PGx) tests it is important to assess whether they provide good value for money. This review provides an update of the literature.
  
  
  METHODS
  A literature search was performed in PubMed and papers published between August 2010 and September 2014, investigating the cost-effectiveness of PGx screening tests, were included. Papers from 2000 until July 2010 were included via two previous systematic reviews. Studies' overall quality was assessed with the Quality of Health Economic Studies (QHES) instrument.
  
  
  RESULTS
  We found 38 studies, which combined with the previous 42 studies resulted in a total of 80 included studies. An average QHES score of 76 was found. Since 2010, more studies were funded by pharmaceutical companies. Most recent studies performed cost-utility analysis, univariate and probabilistic sensitivity analyses, and discussed limitations of their economic evaluations. Most studies indicated favorable cost-effectiveness. Majority of evaluations did not provide information regarding the intrinsic value of the PGx test. There were considerable differences in the costs for PGx testing. Reporting of the direction and magnitude of bias on the cost-effectiveness estimates as well as motivation for the chosen economic model and perspective were frequently missing.
  
  
  CONCLUSIONS
  Application of PGx tests was mostly found to be a cost-effective or cost-saving strategy. We found that only the minority of recent pharmacoeconomic evaluations assessed the intrinsic value of the PGx tests. There was an increase in the number of studies and in the reporting of quality associated characteristics. To improve future evaluations, scenario analysis including a broad range of PGx tests costs and equal costs of comparator drugs to assess the intrinsic value of the PGx tests, are recommended. In addition, robust clinical evidence regarding PGx tests' efficacy remains of utmost importance.
authors.affiliation: Unit of Pharmacotherapy & Pharmaceutical Care, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
authors.forename: Elizabeth J J
authors.initials: EJ
authors.lastname: Berm
authors.affiliation: Unit of PharmacoEpidemiology & PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
authors.forename: Margot de
authors.initials: Md
authors.lastname: Looff
authors.affiliation: Unit of Pharmacotherapy & Pharmaceutical Care, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.|Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Bob
authors.initials: B
authors.lastname: Wilffert
authors.affiliation: Unit of PharmacoEpidemiology & PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.|GSK, Zeist, The Netherlands.
authors.forename: Cornelis
authors.initials: C
authors.lastname: Boersma
authors.affiliation: Faculty of Medicine & Health Science, Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: Lieven
authors.initials: L
authors.lastname: Annemans
authors.affiliation: Unit of PharmacoEpidemiology & PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.|GSK, Zeist, The Netherlands.
authors.forename: Stefan
authors.initials: S
authors.lastname: Vegter
authors.affiliation: Unit of PharmacoEpidemiology & PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
authors.forename: Job F M van
authors.initials: JF
authors.lastname: Boven
authors.affiliation: Unit of PharmacoEpidemiology & PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.|Institute of Science in Healthy Ageing & health care (SHARE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Postma
mesh_terms: D003365:Costs and Cost Analysis; D004353:Drug Evaluation, Preclinical / Q000191:economics*; D017850:Economics, Pharmaceutical; D006801:Humans; D010597:Pharmacogenetics / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome