Economic evaluation of a novel genetic screening test for risk of venous thromboembolism compared with standard of care in women considering combined hormonal contraception in Switzerland
Aim The aim of this study was to assess the cost effectiveness of the Pill Protect (PP) genetic screening test for venous thromboembolism (VTE) risk compared with standard of care (SoC), for women considering combined hormonal contraceptives (CHCs) in Switzerland.Methods A two-part microsimulation m...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2019-11-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/11/e031325.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846150059965546496 |
|---|---|
| author | Zanfina Ademi C Simone Sutherland Matthias Schwenkglenks Nadine Schur Joëlle Michaud Myriam Lingg Arjun Bhadhuri Thierry D. Pache Johannes Bitzer Pierre Suchon Valerie Albert Kurt E. Hersberger Goranka Tanackovic |
| author_facet | Zanfina Ademi C Simone Sutherland Matthias Schwenkglenks Nadine Schur Joëlle Michaud Myriam Lingg Arjun Bhadhuri Thierry D. Pache Johannes Bitzer Pierre Suchon Valerie Albert Kurt E. Hersberger Goranka Tanackovic |
| author_sort | Zanfina Ademi |
| collection | DOAJ |
| description | Aim The aim of this study was to assess the cost effectiveness of the Pill Protect (PP) genetic screening test for venous thromboembolism (VTE) risk compared with standard of care (SoC), for women considering combined hormonal contraceptives (CHCs) in Switzerland.Methods A two-part microsimulation model was developed to estimate VTE events, costs and quality-adjusted life years (QALYs) associated with the PP and SoC strategies. In the first portion of the model, a cohort of 1 million Swiss first-time seekers of a CHC were simulated. It was determined whether each women would receive a CHC or non-CHC by using prescribing patterns elicited from a modified Delphi study. These results formed the basis of the SoC strategy. For the PP strategy, a PP test was included and the results considered in addition to SoC practice. Each woman then entered a Markov model that captured morbidity and mortality over a lifetime. The risk of having a VTE was derived from the risk algorithm that underpins the PP test. The remaining model inputs relating to population characteristics, costs, health resource use, mortality and utilities were derived from published studies or national sources. The model was validated and calibrated to align with population-based studies. Extensive uncertainty analyses were conducted.Results From a Swiss health system perspective, the PP strategy in comparison with the SoC strategy generated an additional CHF 231, and gained 0.003 QALYs per woman, leading to an incremental cost-effectiveness ratio of CHF 76 610 per QALY gained. Assuming a threshold of CHF 100 000 per QALY gained, the PP strategy is likely to be cost effective. Our results were generally robust to variations in the parameter values.Conclusions The PP test may be cost effective in Switzerland for screening women seeking CHCs for their risk of VTE based on the current evidence. |
| format | Article |
| id | doaj-art-cf7065f45fa746728421254ea1594e5e |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-cf7065f45fa746728421254ea1594e5e2024-11-29T06:35:08ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-031325Economic evaluation of a novel genetic screening test for risk of venous thromboembolism compared with standard of care in women considering combined hormonal contraception in SwitzerlandZanfina Ademi0C Simone Sutherland1Matthias Schwenkglenks2Nadine Schur3Joëlle Michaud4Myriam Lingg5Arjun Bhadhuri6Thierry D. Pache7Johannes Bitzer8Pierre Suchon9Valerie Albert10Kurt E. Hersberger11Goranka Tanackovic12School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia1 Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland27 Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland1 Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland3 Gene Predictis SA, Lausanne, Switzerland1 Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland1 Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland4 Women’s Health Watch, Clarens-Montreux, Switzerland3 Department of Obstetrics and Gynaecology, University of Basel, Basel, Switzerland6 Laboratory of Haematology, La Timone Hospital, Marseille, France8 Pharmaceutical Care Research Group (PCRG), University of Basel, Basel, Switzerland8 Pharmaceutical Care Research Group (PCRG), University of Basel, Basel, Switzerland3 Gene Predictis SA, Lausanne, SwitzerlandAim The aim of this study was to assess the cost effectiveness of the Pill Protect (PP) genetic screening test for venous thromboembolism (VTE) risk compared with standard of care (SoC), for women considering combined hormonal contraceptives (CHCs) in Switzerland.Methods A two-part microsimulation model was developed to estimate VTE events, costs and quality-adjusted life years (QALYs) associated with the PP and SoC strategies. In the first portion of the model, a cohort of 1 million Swiss first-time seekers of a CHC were simulated. It was determined whether each women would receive a CHC or non-CHC by using prescribing patterns elicited from a modified Delphi study. These results formed the basis of the SoC strategy. For the PP strategy, a PP test was included and the results considered in addition to SoC practice. Each woman then entered a Markov model that captured morbidity and mortality over a lifetime. The risk of having a VTE was derived from the risk algorithm that underpins the PP test. The remaining model inputs relating to population characteristics, costs, health resource use, mortality and utilities were derived from published studies or national sources. The model was validated and calibrated to align with population-based studies. Extensive uncertainty analyses were conducted.Results From a Swiss health system perspective, the PP strategy in comparison with the SoC strategy generated an additional CHF 231, and gained 0.003 QALYs per woman, leading to an incremental cost-effectiveness ratio of CHF 76 610 per QALY gained. Assuming a threshold of CHF 100 000 per QALY gained, the PP strategy is likely to be cost effective. Our results were generally robust to variations in the parameter values.Conclusions The PP test may be cost effective in Switzerland for screening women seeking CHCs for their risk of VTE based on the current evidence.https://bmjopen.bmj.com/content/9/11/e031325.full |
| spellingShingle | Zanfina Ademi C Simone Sutherland Matthias Schwenkglenks Nadine Schur Joëlle Michaud Myriam Lingg Arjun Bhadhuri Thierry D. Pache Johannes Bitzer Pierre Suchon Valerie Albert Kurt E. Hersberger Goranka Tanackovic Economic evaluation of a novel genetic screening test for risk of venous thromboembolism compared with standard of care in women considering combined hormonal contraception in Switzerland BMJ Open |
| title | Economic evaluation of a novel genetic screening test for risk of venous thromboembolism compared with standard of care in women considering combined hormonal contraception in Switzerland |
| title_full | Economic evaluation of a novel genetic screening test for risk of venous thromboembolism compared with standard of care in women considering combined hormonal contraception in Switzerland |
| title_fullStr | Economic evaluation of a novel genetic screening test for risk of venous thromboembolism compared with standard of care in women considering combined hormonal contraception in Switzerland |
| title_full_unstemmed | Economic evaluation of a novel genetic screening test for risk of venous thromboembolism compared with standard of care in women considering combined hormonal contraception in Switzerland |
| title_short | Economic evaluation of a novel genetic screening test for risk of venous thromboembolism compared with standard of care in women considering combined hormonal contraception in Switzerland |
| title_sort | economic evaluation of a novel genetic screening test for risk of venous thromboembolism compared with standard of care in women considering combined hormonal contraception in switzerland |
| url | https://bmjopen.bmj.com/content/9/11/e031325.full |
| work_keys_str_mv | AT zanfinaademi economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT csimonesutherland economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT matthiasschwenkglenks economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT nadineschur economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT joellemichaud economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT myriamlingg economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT arjunbhadhuri economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT thierrydpache economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT johannesbitzer economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT pierresuchon economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT valeriealbert economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT kurtehersberger economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland AT gorankatanackovic economicevaluationofanovelgeneticscreeningtestforriskofvenousthromboembolismcomparedwithstandardofcareinwomenconsideringcombinedhormonalcontraceptioninswitzerland |