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Cost-utility analysis of pharmacogenomics-guided tacrolimus treatment in Austrian kidney transplant recipients participating in the U-PGx PREPARE study

The Pharmacogenomics Journal volume 24, Article number: 10 (2024) Cite this article

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Abstract

Chronic kidney disease (CKD) is a global health issue. Kidney failure patients may undergo a kidney transplantation (KTX) and prescribed an immunosuppressant medication i.e., tacrolimus. Tacrolimus’ efficacy and toxicity varies among patients. This study investigates the cost-utility of pharmacogenomics (PGx) guided tacrolimus treatment compared to the conventional approach in Austrian patients undergone KTX, participating in the PREPARE UPGx study. Treatment’s effectiveness was determined by mean survival, and utility values were based on a Visual Analog Scale score. Incremental Cost-Effectiveness Ratio was also calculated. PGx-guided treatment arm was found to be cost-effective, resulting in reduced cost (3902 euros less), 6% less hospitalization days and lower risk of adverse drug events compared to the control arm. The PGx-guided arm showed a mean 0.900 QALYs (95% CI: 0.862–0.936) versus 0.851 QALYs (95% CI: 0.814–0.885) in the other arm. In conclusion, PGx-guided tacrolimus treatment represents a cost-saving option in the Austrian healthcare setting.

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Fig. 1: Scatter plot of probabilistic analysis.
Fig. 2: Cost-effectiveness acceptability curve of PGx-guided group vs control group.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

The project was funded by the European Commission Horizon 2020 Program via Grant Agreement 668353 (U-PGx; www.upgx.eu) to CM.

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Author notes

  1. These authors contributed equally: Vasileios Fragoulakis, Margarita-Ioanna Koufaki.

Authors and Affiliations

  1. The Golden Helix Foundation, London, UK

    Vasileios Fragoulakis & Christina Mitropoulou

  2. Department of Pharmacy, Laboratory of Pharmacogenomics and Individualized Therapy, University of Patras, School of Health Sciences, Patras, Greece

    Margarita-Ioanna Koufaki

  3. Department of Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria

    Candace Joefield-Roka & Gere Sunder-Plassmann

  4. Department of Genetics and Genomics, United Arab Emirates University, College of Medicine and Health Sciences, Al-Ain, Abu Dhabi, United Arab Emirates

    Christina Mitropoulou

Authors
  1. Vasileios Fragoulakis
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  4. Gere Sunder-Plassmann
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  5. Christina Mitropoulou
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Contributions

All authors contributed to the conception, design and drafting of the paper. CJR and GSP performed data collection and documentation in eCRF and were part of the Austrian clinical team working on the PREPARE study. CM was one of the delegated persons, responsible for the design and the conduction of PREPARE project. VF and MIK reviewed and purified the study’s database. VF and MIK conducted data analysis. VF and MIK drafted the first and all subsequent versions of this paper. All authors reviewed and approved the final version of paper. VF and MIK are the guarantor for the overall content.

Corresponding author

Correspondence to Christina Mitropoulou.

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The authors declare no competing interests.

Ethics approval

The study was approved by ethics committee of the Medical University of Vienna, Vienna, Austria.

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Fragoulakis, V., Koufaki, MI., Joefield-Roka, C. et al. Cost-utility analysis of pharmacogenomics-guided tacrolimus treatment in Austrian kidney transplant recipients participating in the U-PGx PREPARE study. Pharmacogenomics J 24, 10 (2024). https://doi.org/10.1038/s41397-024-00330-5

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  • DOI: https://doi.org/10.1038/s41397-024-00330-5

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