TY  - JOUR
T1  - Cost-Effectiveness of an Expanded Pharmacogenomic Panel (HLA-B, HLA-DQB1, and SLCO1B3-SLCO1B7) for Preventing Clozapine-Induced Agranulocytosis/Granulocytopenia: A 10-Year Decision-Analytic Model
A1  - Sara Lindberg
A1  - Johanna Eriksson
A1  - Helena Bergstrom
A1  - Karin Olsson
JF  - Specialty Journal of Pharmacognosy, Phytochemistry, and Biotechnology
JO  - Spec J Pharmacogn Phytochem Biotechnol
SN  - 3062-441X
Y1  - 2025
VL  - 5
IS  - 1
DO  - 10.51847/PLV0OMQ3wK
SP  - 96
EP  - 103
N2  - Growing efforts have focused on uncovering pharmacogenetic contributors that heighten the likelihood of clozapine-associated agranulocytosis or granulocytopenia (CIAG). Three markers—the SLCO1B3-SCLO1B7 polymorphism (rs149104283) and specific single–residue substitutions in the human leukocyte antigen (HLA) region, HLA-DQB1 (126Q) and HLA-B (158T)—have been linked to elevated CIAG risk. In this analysis, we examined both the clinical impact and economic implications of supplementing existing HLA-based screening with the SLCO1B3-SCLO1B7 variant as an expanded pharmacogenomic (PGx) approach, and assessed outcomes in a population of individuals with schizophrenia using clozapine as a third-line therapy. The decision framework incorporated deterministic and probabilistic sensitivity assessments to estimate total costs and quality-adjusted life-years (QALYs). Over a 10-year period, the current monitoring program was evaluated against a PGx-based pathway in which all patients receive genetic testing before beginning clozapine. Incorporating the SLCO1B3-SCLO1B7 variant increased CIAG detection sensitivity from 36.0% to 43.0%, reduced specificity from 89.0% to 86.9%, and raised the probability of being cost-effective from 74.1% to 87.8%. The incremental cost-effectiveness ratio was £16,215 per QALY, staying underneath the conventional threshold (£30,000 or US$50,000 per QALY). These findings indicate that adding the SLCO1B3-SCLO1B7 marker to HLA alleles improves pre-emptive test performance and enhances both the clinical and economic utility of PGx-guided clozapine treatment.
UR  - https://galaxypub.co/article/cost-effectiveness-of-an-expanded-pharmacogenomic-panel-hla-b-hla-dqb1-and-slco1b3-slco1b7-for-p-vzbbopidwcqvzpl
ER  -