Relationships between PTTR, bleeds and TEs were based on data from literature (2).
Based on these observations, the PTTR was calculated for the SOC dosing strategy branch at month 1 and averaged for months 2-6.
After performing the Tornado analysis (Figure 3), it revealed that the ICUR was more sensitive to the cost of the pharmacogenomic testing, followed by the increase in PTTR offered by the PGx.
Given the fact that under no scenario the PGx demonstrated a higher cost-utility than the SOC (i.e., if the cost of genotyping is $300 and the effectiveness of the PGx is found to be limited to an 8% increase in the PTTR), pharmacogenetic testing should not be routinely recommended in current practice for every single patient at VACHS.
Additionally, Meckley et al (2) considered additional risk of bleeds in CYP2C9 variant patients independent of the PTTR. In this study, a more conservative approach was taken, since the risk of bleeding was based solely on the PTTR.