Page 185 - Personalised medicine of fluoropyrimidines using DPYD pharmacogenetics Carin Lunenburg
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Cost analysis on DPYD genotype-guided dosing
allele carrier receiving standard dose, and DPYD genotyping costs. However, in all cases, the cost-saving remained positive.
Results of the simulations for the probabilistic sensitivity analysis are depicted in Figure 4. Average cost-savings from the simulation in the probabilistic sensitivity analysis were €52 per patient (95%-interval range -€38 to €176). Average gain in safety was 0.89% (95%-interval range -0.04% to 1.79%). This gain in safety represents the difference between the proportion of patients treated without severe toxicity (both wild-type patients and DPYD variant allele carriers taken together) in the screening strategy and the non-screening strategy.
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Figure 3. One-way sensitivity analysis of upfront DPYD genotyping versus non-screening
All parameters were individually varied by ±20% (-20% depicted in blue, +20% depicted in green), effects of which cost-savings are indicated by horizontal bars. The vertical line indicates the baseline costs savings of €50.
Figure 4. Probabilistic sensitivity analysis of the cost analysis
For this sensitivity analysis, all parameters were varied simultaneously by running 1,000 Monte Carlo simulations. The red square indicates the observed values.
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