OBJECTIVES: Drug side effects and ineffectiveness are a source of morbidity, significant disability, and mortality worldwide and increase the overall cost of care. Pharmacogenetics explore a patient’s risk for drug side effects and ineffectiveness and identify the most suitable medication. This research explores cost-effectiveness and potential budget impact on the National Organization for Healthcare Services in Greece (EOPYY), of the iDNA PGx-CNS, an in vitro diagnostic pharmacogenetics test for the treatment of Drug Resistant Depression (DRD). This test examines the proven interaction of drugs administered to patients with Major Depressive Disorder with genetic polymorphisms, as reflected in the most recent international scientific literature and pharmacogenetic databases.

METHODS: An economic model was developed for its financial evaluation, that calculates cost-effectiveness analysis (deterministic analysis) and probabilistic sensitivity analysis (PSA). The study included 2 groups of patients (n=100,00), pharmacogenetic-guided versus treatment as usual. The time horizon of the study was defined as 12 months, through the EOPYY’s perspective. Data inputs to populate the decision tree were derived from the literature, Greek cost data sources, and from a panel of psychiatry experts.

RESULTS: In comparison to conventional treatment, treatment with iDNA PGx-CNS was found to be a cost-effective intervention with ICER Q € 55, which is almost minimal compared to the conventional average (€ 34,242) and the lowest ratio (€ 17,121). Further, its impact is rather limited on the Organization’s budget as even in the hypothetical scenario of the use of iDNA PGx-CNS by all patients with DRD, the 5-year cumulative total financial burden does not exceed 1 million Euros. The analysis also showed a significant reduction in suicides; 638 fewer deaths from patient suicide in 5 years, in the pharmacogenetic-guided arm.

CONCLUSIONS: Hence, pharmacogenetic guidance is cost-effective and advances the individualized choice of the most effective, safe, and best tolerable medication for each patient.