Cost-effectiveness analysis of UGT1A1*6/*28 genotyping for preventing FOLFIRI-induced severe neutropenia in Chinese colorectal cancer patients

Pharmacogenomics. 2019 Mar;20(4):241-249. doi: 10.2217/pgs-2018-0138. Epub 2019 Jan 10.

Abstract

Aim: To assess the cost-effectiveness of UGT1A1*6/*28 genotyping compared with no genotyping or no dose adjustment before irinotecan administration in China.

Materials & methods: A decision tree model was developed to evaluate costs and health outcomes represented as quality-adjusted life years gained. Model inputs for the frequency of genotypes, the probability of neutropenia under FOLFIRI chemotherapy and direct costs and utilities were obtained from published sources. One-way sensitivity analyses were performed.

Results: The strategy of genotyping with dose reduction dominated all remaining strategies. Compared with the strategies of no genotyping and genotyping with unchanged dose, it resulted in only marginal quality-adjusted life year increases (0.0011 and 0.0012) but a cost reduction of $651.12 and $805.22 per patient, respectively. One-way sensitivity analyses revealed that the model was relatively robust.

Conclusion: UGT1A1*6/*28 genotyping was cost saving for Chinese colorectal cancer patients.

Keywords: FOLFIRI; colorectal cancer; cost–effectiveness; irinotecan.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Camptothecin / adverse effects
  • Camptothecin / analogs & derivatives*
  • China / epidemiology
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / pathology
  • Cost-Benefit Analysis
  • Drug-Related Side Effects and Adverse Reactions / genetics
  • Drug-Related Side Effects and Adverse Reactions / pathology
  • Female
  • Fluorouracil / adverse effects
  • Genotyping Techniques / economics
  • Glucuronosyltransferase / genetics*
  • Humans
  • Leucovorin / adverse effects
  • Male
  • Middle Aged
  • Neutropenia / chemically induced
  • Neutropenia / genetics*
  • Neutropenia / pathology

Substances

  • UGT1A1 enzyme
  • Glucuronosyltransferase
  • Leucovorin
  • Fluorouracil
  • Camptothecin

Supplementary concepts

  • IFL protocol