Pharmacogenomic Testing to Guide Antidepressant Use Beneficial in Major Depression

Pharmacogenomic testing predicted to save the health system $956 million and bring health gains of 0.381 QALYs per patient

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Nov. 22, 2023 (HealthDay News) — For patients with major depressive disorder, pharmacogenomics testing to guide antidepressant use yields population health gains and reduces health system costs, according to a study published online Nov. 14 in CMAJ, the journal of the Canadian Medical Association.

Shahzad Ghanbarian, Ph.D., from the University of British Columbia in Vancouver, Canada, and colleagues developed a discrete-time microsimulation model of care pathway for major depressive disorder in British Columbia to examine the effectiveness and cost-effectiveness of pharmacogenomic testing from the public payer’s perspective. Incremental costs, life-years, and quality-adjusted life-years (QALYs) were estimated for a representative cohort of patients.

The researchers found that pharmacogenomic testing was predicted to save the British Columbia health system $956 million over 20 years ($4,926 per patient) and bring health gains of 0.064 and 0.381 life-years and QALYs per patient, respectively, if implemented for adult patients with moderate-to-severe major depressive disorder. The savings were mostly as a result of slowing or preventing the transition to refractory depression. Over 20 years, pharmacogenomic-guided care was associated with 37 percent fewer patients with refractory depression. The costs of pharmacogenomics testing would be offset within about two years of implementation as estimated in sensitivity analyses.

“Interventions that might improve remission rates and reduce the number of cases of refractory depression, in particular, are needed to improve the quality of life for patients, and reduce the economic burden of major depressive disorder on already strained health care systems,” the authors write.