title: HLA-B*57: 01 genotyping in the prevention of hypersensitivity to abacavir: 5 years of experience.
abstract: Most of the cost-effectiveness analyses are based on estimations to make decisions on the future implementation of a test. However, the model should be verified with real data to prove that previous estimations have been successfully fulfilled.
  
  
  
  To study the economic impact of the systematic HLA-B*57:01 genotyping in preventing hypersensitivity reactions (HSRs) in the patient population of a tertiary-care hospital treated with abacavir (ABC) using retrospective data of 5 years of experience.
  
  
  
  A retrospective study was carried out with two cohorts including 780 and 473 patients before and after the implementation of the systematic HLA-B*57:01 genotyping before ABC treatment. Cost-effectiveness analysis was carried out by the parameter 'cost per HSR avoided'. The clinical utility of the test was verified by evaluating the differences in HSR incidence between both cohorts. Finally, a sensitivity analysis including all variables was carried out.
  
  
  
  In the population studied, systematic genotyping represents an additional cost of &OV0556;306 per HSR avoided. In the sensitivity analysis, pharmacological therapy cost is the major influencing factor found in the estimation of the 'cost per HSR avoided'. In terms of clinical utility, the incidence ratio was 0.040 (95% confidence interval 0.0009-0.2399) and statistically significant differences were found between both groups (P=1.40×10).
  
  
  
  Retrospective data from 5 years of experience have confirmed the cost-effectiveness of the systematic genotyping in candidate patients for ABC therapy, and have shown that cost-effectiveness is a dynamic parameter closely linked to allele prevalence and pharmacological therapy costs.
authors.affiliation: Departments of aMolecular Genetics, Clinical Laboratory bPharmacy cHIV Unit, Department of Infectious Diseases, Bellvitge-IDIBELL University Hospital, L'Hospitalet de Llobregat dRheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Ruiz-Iruela
authors.forename: Núria
authors.initials: N
authors.lastname: Padullés-Zamora
authors.forename: Daniel
authors.initials: D
authors.lastname: Podzamczer-Palter
authors.forename: Arnald
authors.initials: A
authors.lastname: Alonso-Pastor
authors.forename: Beatriz
authors.initials: B
authors.lastname: Candás-Estébanez
authors.forename: Pedro
authors.initials: P
authors.lastname: Alía-Ramos
authors.forename: Ariadna
authors.initials: A
authors.lastname: Padró-Miquel
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D003362:Cost-Benefit Analysis; D015224:Dideoxynucleosides / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000235:genetics / Q000276:immunology / Q000517:prevention & control*; D005260:Female; D005838:Genotype; D006679:HIV Seropositivity / Q000188:drug therapy*; D015497:HIV-1 / Q000276:immunology*; D015235:HLA-B Antigens / Q000235:genetics*; D006801:Humans; D008297:Male; D010597:Pharmacogenetics; D012189:Retrospective Studies; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D015235:HLA-B Antigens; D000099227:Abacavir; C103707:HLA-B57 antigen