title: Economic Evaluation of Pharmacogenetic Tests in Patients Subjected to Renal Transplantation: A Review of Literature.
abstract: Renal transplantation is the treatment of choice for the patients with end-stage renal failure. Genetic factors, among others, can influence variability in response to immunosuppressive drugs. Nowadays, due to restrictive health resources, the question arises whether routine pharmacogenetic analyses should be done in the renal transplant recipients or not. The aim of this literature review was to present the up-to-date information considering the economic feasibility of pharmacogenetic testing in patients subjected to renal transplantation. The organization United Network for Organ Sharing in the US estimated that total costs per renal transplant concerning these analyses were $334,300 in 2014. Pharmacogenetic testing prior to treatment initiation could be helpful to predict and assess treatment response and the risks for adverse drug reactions. This kind of testing before treatment initiation seems to be one of the most promising applications of pharmacokinetics. Although pharmacogenetic tests were found to be a cost-effective or cost-saving strategy in many cases, some authors represent another opinion. However, if the real costs of renal transplantation are recognized, the application of these tests in the standard daily practice could be considered more realistic, which additionally emphasizes the importance of future studies assessing their cost effectiveness.
authors.affiliation: Centre for Clinical Pharmacology, Military Medical Academy Medical Faculty, University of Defence , Belgrade , Serbia.
authors.forename: Nemanja
authors.initials: N
authors.lastname: Rancic
authors.affiliation: Centre for Clinical Pharmacology, Military Medical Academy Medical Faculty, University of Defence , Belgrade , Serbia.
authors.forename: Viktorija
authors.initials: V
authors.lastname: Dragojevic-Simic
authors.affiliation: Solid Organ Transplantation Center, Military Medical Academy , Belgrade , Serbia.
authors.forename: Neven
authors.initials: N
authors.lastname: Vavic
authors.affiliation: Centre for Clinical Pharmacology, Military Medical Academy Medical Faculty, University of Defence , Belgrade , Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Kovacevic
authors.affiliation: Management of the Military Medical Academy, Military Medical Academy Medical Faculty, University of Defence , Belgrade , Serbia.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Segrt
authors.affiliation: Department of Pharmacology and Toxicology, The Faculty of Medical Sciences, University of Kragujevac , Kragujevac , Serbia.
authors.forename: Natasa
authors.initials: N
authors.lastname: Djordjevic
keywords: genetic polymorphisms; health economics; immunosuppressive drugs; pharmacogenetic tests; renal transplantation