Cost effectiveness analysis of HLA-B*58:01 genotyping prior to initiation of allopurinol for gout

Catrin Plumpton; Ana Alfirevic; Munir Pirmohamed; Dyfrig Hughes

doi:10.1093/rheumatology/kex253

Cost effectiveness analysis of HLA-B*58:01 genotyping prior to initiation of allopurinol for gout

Catrin Plumpton, Ana Alfirevic, Munir Pirmohamed, Dyfrig Hughes

University of Liverpool

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Abstract

(ICER) of £44,954 per QALY gained. The probability of testing being cost-effective at a threshold of £30,000 per QALY was 0.25. Reduced costs of testing or febuxostat resulted in an ICER below £30,000 per QALY gained. The ICER for patients with chronic renal insufficiency was £38,478 per QALY gained.
Conclusion: Routine testing for HLA-B*58:01 in order to reduce the incidence of adverse drug reactions in patients being prescribed allopurinol for gout is unlikely to be cost-effective in the UK; however testing is expected to become cost-effective with reductions in the cost of genotyping, and with the future availability of cheaper, generic febuxostat.

Original language	English
Pages (from-to)	1729-1739
Journal	Rheumatology
Volume	56
Issue number	10
Early online date	14 Jul 2017
DOIs	https://doi.org/10.1093/rheumatology/kex253
Publication status	Published - 1 Oct 2017

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title = "Cost effectiveness analysis of HLA-B*58:01 genotyping prior to initiation of allopurinol for gout",

abstract = "(ICER) of £44,954 per QALY gained. The probability of testing being cost-effective at a threshold of £30,000 per QALY was 0.25. Reduced costs of testing or febuxostat resulted in an ICER below £30,000 per QALY gained. The ICER for patients with chronic renal insufficiency was £38,478 per QALY gained. Conclusion: Routine testing for HLA-B*58:01 in order to reduce the incidence of adverse drug reactions in patients being prescribed allopurinol for gout is unlikely to be cost-effective in the UK; however testing is expected to become cost-effective with reductions in the cost of genotyping, and with the future availability of cheaper, generic febuxostat.",

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N2 - (ICER) of £44,954 per QALY gained. The probability of testing being cost-effective at a threshold of £30,000 per QALY was 0.25. Reduced costs of testing or febuxostat resulted in an ICER below £30,000 per QALY gained. The ICER for patients with chronic renal insufficiency was £38,478 per QALY gained. Conclusion: Routine testing for HLA-B*58:01 in order to reduce the incidence of adverse drug reactions in patients being prescribed allopurinol for gout is unlikely to be cost-effective in the UK; however testing is expected to become cost-effective with reductions in the cost of genotyping, and with the future availability of cheaper, generic febuxostat.

AB - (ICER) of £44,954 per QALY gained. The probability of testing being cost-effective at a threshold of £30,000 per QALY was 0.25. Reduced costs of testing or febuxostat resulted in an ICER below £30,000 per QALY gained. The ICER for patients with chronic renal insufficiency was £38,478 per QALY gained. Conclusion: Routine testing for HLA-B*58:01 in order to reduce the incidence of adverse drug reactions in patients being prescribed allopurinol for gout is unlikely to be cost-effective in the UK; however testing is expected to become cost-effective with reductions in the cost of genotyping, and with the future availability of cheaper, generic febuxostat.

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JO - Rheumatology

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Cost effectiveness analysis of HLA-B*58:01 genotyping prior to initiation of allopurinol for gout

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