ABSTRACT
The introduction of pharmacogenomics in clinical practice can provide physicians with tools to assess risks and benets associated with using available medicines for particular patients, and to select therapies tailored to each patient or subgroup of patients. The use of pharmacogenomic testing in clinical practice is limited thus far. Nevertheless, current and emerging advances suggest that better targeted and more effective pharmacogenomic-based treatments have the potential to yield signicant gains in personal health, population health and cost-effective resource allocation. Current “trial and error” approaches to pharmaceutical therapy contributes to nearly 3 million incorrect or ineffective drug prescriptions annually in the US (SACGHS 2007). In contrast to that approach, pharmacogenomics has great potential to increase the safety and effectiveness of drugs by identifying those at risk of adverse events, and by helping physicians to prescribe drugs and dosages in ways that are more likely to t individual patient responses. A potential barrier to the widespread implementation of pharmacogenomic-based diagnostic screening could be the lack of evidence on whether testing provides good value for money. In general terms, testing before treating is economically viable if the savings gained by avoiding ineffective treatment and adverse events are greater than the cost of testing. The goal of this chapter is twofold: rst, to provide an overview of experiences so far in conducting economic evaluation studies focused on the combination of genetic testing and drug. Second, to analyze specic examples where the application of pharmacogenomic testing may be regarded as promising in terms of efciency.
