Patient preferences for pharmacogenetic screening in depression
Louise Herbild1, Dorte Gyrd-Hansen, Mickael Bech
1Danish Institute for Health Services Research, Copenhagen, Denmark. loh@dsi.dk
International Journal of Technology Assessment in Health Care
|January 26, 2008
Summary
Patients are willing to pay for genetic screening to reduce antidepressant medication shifts. The value of genetic screening exceeds its cost when it reduces medication changes, indicating a focus on outcomes rather than genetic information itself.
Area of Science:
- Pharmacogenomics
- Health Economics
Background:
- Depression treatment often involves trial-and-error with antidepressant medications.
- Genetic screening, such as for CYP2D6 polymorphisms, may personalize treatment and reduce adverse outcomes.
- Understanding patient preferences and willingness-to-pay (WTP) is crucial for adopting new diagnostic tools.
Purpose of the Study:
- To estimate patient preferences and WTP for genetic screening for CYP2D6 polymorphisms.
- To assess the value patients place on attributes related to genetic screening in depression management.
Main Methods:
- A web-based discrete choice questionnaire was administered to 89 former and current depressed patients.
- Key attributes included shifts in medication, time without symptom relief, side-effects, and screening cost.
- A switching model compared patient treatment history with a scenario incorporating genetic screening.
Main Results:
- Increased medication shifts, time without symptom relief, and screening cost decreased the likelihood of choosing genetic screening.
- Screening cost and the number of medication shifts were significant factors influencing patient choice.
- Marginal WTP for a 5% probability of reducing one antidepressant shift was DKK2,599 (approximately €350).
Conclusions:
- Patients prioritize reductions in antidepressant medication shifts and cost when considering genetic screening.
- The perceived value of genetic screening is linked to its potential to improve treatment outcomes, not the genetic information itself.
- The WTP for genetic screening, when it offers a tangible reduction in medication shifts, surpasses its cost.
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