TDNet Discover

Background/Objective: Pharmacogenetic (PGx) guided antidepressant therapy has become an alternative management approach for major depressive disorder (MDD). Extensive research has demonstrated an improvement in response rates and outcomes in major depressive disorder treated with PGx guided therapy. An evidence-based medicine systematic-review was undertaken to assess the cost effectiveness of current pharmacogenetic testing for antidepressants in the treatment of Major Depressive Disorder. Data sources: PubMed, Discover Search at South College, Google Scholar, and ProQuest Psychology databases were systematically searched to find relevant articles published prior to February 2020. Search terms included various combinations of the following: pharmacogenetic testing, antidepressants, major depressive disorder, cost-effectiveness. Study selection: Only 13 articles out of 75 initially identified articles met the inclusion/exclusion criteria to qualify for full text analysis. Three articles with the highest evidence and applicability were selected for comparison. Data extraction: Manual data extraction was carried out for all three articles. Results: Two separate economic modeling analyses of the same RCT, which compared pharmacogenetic (PGx) testing guided therapy (NeuroIDGx® ) to the “trial and error” approach reported a cost benefit to the PGx guided approach. However, funding for both analyses came from the creators of the PGx commercial test. One grant-sponsored, nonrandomized, case control analysis reported a cost-benefit to PGx guided therapy over a six-month period, but the upfront cost of the PGx commercial test was not included. Conclusion: Pharmacogenetic testing was determined to provide a cost benefit for patients with moderate to severe unipolar depression, but study flaws and potential bias suggest that additional studies with non-private funding and larger sample sizes are needed.