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

Objectives: To assess the cost-effectiveness of Arg16Gly pharmacogenomic testing compared with no Arg16Gly testing to guide the use of long-acting β 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 genotyping group. Therefore, the Arg16Gly test group was the dominant strategy for children with asthma in China. The sensitivity analyses showed that the model was relatively stable.

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