Stated Preferences for Attributes of a CYP2C19 Pharmacogenetic Test Among the General Population Presented with a Hypothetical Acute Coronary Syndrome Scenario

Abstract

Background

Pharmacogenetic (PGx) testing identifies pharmacotherapeutic risks to permit personalized therapy. Identifying the genetic profile of patients with acute coronary syndrome (ACS) who are considered for therapy with clopidogrel (P2Y₁₂ receptor blockers) and acetylsalicylic acid (ASA) contributes to the treatment paradigm. Patient preferences would inform a collaborative framework and by extension inform healthcare policy formulation.

Purpose

To quantify stated preferences (willingness to pay) for attributes of a novel point-of-care PGx (CYP2C19) test using a discrete choice experiment (DCE) from the general public in Ontario, Canada, and to identify starting point bias of the cost attribute.

Methods

A web survey was created and included a questionnaire, decision board, and a DCE. DCE choice sets include the following attributes (levels): sample collection (blood, finger prick, and cheek swab), turnaround time for results (1 hr, 3 days, and 1 week), and cost in additional insurance premiums. The presence of starting point bias (cost attribute levels of $0, $1, $5 or $0, $2, $10) in the estimation of willingness to pay (WTP) was tested.

Results

Estimates for turnaround time and cost attributes were statistically significant. Coefficients related to the starting point bias were also significant. Approximately 67% of survey participants chose the PGx test compared to status quo treatment options. WTP for a 1 hr turnaround time compared to a 1-week turnaround time was $10.77 (95% CI 9.58 -12.25).

Conclusion

This translational study shows preference for a point of care PGx test.

Keywords:

• discrete choice experiment
• pharmacogenetic test
• patient preference
• starting point bias

Acknowledgments

The authors would like to thank Dr. Christopher J. Longo for his guidance and Mr. Peter Woods for the web platform creation.

Disclosure

Dr. So has received unrestricted grant support (physician-initiated grant) from Eli Lilly Canada; is a member of the advisory board and has received honoraria from AstraZeneca Canada; is a member of the advisory board for Bayer Canada; has received unrestricted grant support (physician-initiated grant) from Spartan Biosciences; has received unrestricted grant support (physician-initiated grant) from Aggredyne; has received unrestricted grant support (physician-initiated grant) from Diapharma/Roche Diagnostics; and has received honoraria from Abbott Vascular, Canada. Dr. Emmanuel Papadimitropoulos is an employee of Eli Lilly Canada Inc, outside the submitted work. The authors report no other conflicts of interest in this work.