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Genetic testing for guiding warfarin dose

In September 2007 the U.S. Food and Drug Administration (FDA) approved a new genetic test to help physicians determine whether a patient may be sensitive to the blood thinning drug warfarin.

However, a new analysis has shown that genetic testing to guide initial dosing of warfarin may not be cost effective for typical patients with atrial fibrillation.

The genetic test study

Prof Eckman from the University of Cincinnati lead the study which looked at whether the benefit of testing is worth the costs associated with it.

Researchers analyzed the results of three clinical studies published to see whether genetic guided dosing decreases the risk of major bleeds, compared to standard treatment with warfarin.

They found that genetic guided dosing resulted in better outcomes, but it was at a relatively high cost, over $170,000 for each year gained.

Researchers conclusions

The research suggests that genetic guided dosing might be worth the costs if is used for patients at high risk for hemorrhage, gives a fast result (less than 24hrs) and costs less than $200.

Prof Eckman said, “This could be accomplished if testing were done in-house, at lower cost and without delays.”

He added, “Personalized, predictive medicine offers great promise, but we need to carefully examine the benefits and understand the cost-effectiveness of such strategies before we spend a lot of money on very expensive tests.”

This study was published in the January 2009, edition of Annals of Internal Medicine.

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