Cost-effectiveness of Arg16Gly in ADRB2 pharmacogenomic-guided treatment for pediatric asthma

ABSTRACT

Objectives

To assess the cost-effectiveness of Arg16Gly ADRB2 pharmacogenomic testing compared with no Arg16Gly ADRB2 testing to guide the use of long-acting β₂ receptor agonist (LABA) in asthma patients aged 1 to 5 years in China.

Methods

This economic evaluation developed a Markov model with four health states (no exacerbation, mild exacerbation, moderate-to-severe exacerbation, and death). Transition probabilities were estimated from the rate of exacerbations, the case-fatality rate of patients hospitalized for exacerbations, and natural mortality. Costs included drug costs and exacerbation management costs. Cost inputs and utilities for each health state were gained from public databases and the literatures. Costs and quality-adjusted life years (QALYs) were estimated for ten years. Deterministic and probabilistic sensitivity analyses were performed.

Results

In the base case analysis, in contrast to the group without the genotype test, the incremental total cost was -¥334.7, and the incremental QALY was 0.001 in the Arg16Gly ADRB2 genotyping group. Therefore, the Arg16Gly ADRB2 test group was the dominant strategy for children with asthma in China. The sensitivity analyses showed that the model was relatively stable.

Conclusion

Arg16Gly ADRB2 testing before using LABA is a cost-effective approach compared with no gene testing for pediatric asthma.

KEYWORDS:

• Cost-effectiveness analysis
• pediatric asthma
• Arg16gly ADRB2 pharmacogenomic test
• LABA
• quality-adjusted life years

Acknowledgments

The authors thank the researchers whose clinical trials were included in the cost-effectiveness analysis.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

X Li and Y Cao designed this study, supervised the data collected, and proposed suggestions for revising the manuscript. Literature analysis were done by X Li, and X Li and Y Cao built the model using software, collected the data for model, and operated model. X Li drafted the manuscript. All authors critically reviewed the manuscript and approved the final version of the manuscript. All authors agree to be accountable for the content of the work.

Ethical statement

Ethical approval and informed consent from the patients were not required in this study, because the research data is publicly available.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2220966.

Additional information

Funding

This paper was not funded.