COST-EFFECTIVENESS ANALYSIS OF CYP2D6 GENOTYPING TO GUID NORTRIPTYLINE THERAPY AMONG U.S. HOSPITALIZED PATIENTS WITH MAJOR DEPRESSIVE DISORDER

Abstract

Objectives: The objective of the study was to determine the incremental costs of CYP2D6 genotyping in reducing the length of hospitalization in depressed elderly U.S. patients treated with nortriptyline Method: The cost-effectiveness analysis of depressed hospitalized U.S. population of 60 years and older starting nortriptyline therapy was conducted. Costs, estimates of parameters, and sensitivity analyses were determined from expert opinion and the literature. Probabilistic sensitivity analyses were administered to assess the firmness of the results Result: An incremental cost-effectiveness of $862 for White genotyped compared to Care as usual per hospital day avoided was displayed in the probabilistic sensitivity analysis. Results were sensitive to the probability of being UM for White, the probability of being supratherapeutic until 2nd evaluation PM, and the probability of being PM for White. Conclusion: The value of ICER was lower when evaluating subjects from European Caucasian populations. Therefore, genotyping may demonstrate good value for money in certain populations. With increasing the need for individualized medicine, these outcomes are beneficial for policymakers and physicians