Feng, Xiaodong_ Xie, Hong-Guang - Applying pharmacogenomics in therapeutics-CRC Press (2016)

282 Applying Pharmacogenomics in Therapeutics
and testing assay in nature as summarized in Table 11.1. More ICE ratio is expected
for the drug whose therapeutic window is narrow, whose treatment response is
highly variable and difficult to measure, and whose indication is a severe chronic
disease that is difficult to treat. Because PGx strategies cannot be assumed to be
cost-effective, it should be required to perform a comprehensive CEA evaluation of
a new PGx-based intervention in advance of its translation to patient care. With rapid
advances in genetic technologies, a dramatic decrease in the cost of genetic testing
itself has made such tests affordable. To date, most of our research efforts made for
PGx studies have been focused on their clinical validity—making the science make
sense. Now is the time to increase the research efforts on the clinical utility of economic
evaluation of PGx and to further improve the PGx knowledge base for clinical
and economic integration and decision making.
ACKNOWLEDGMENTS
This work is supported, at least in part, by the research grants 81473286 by the
National Natural Science Foundation of China (NSFC); BL2013001 from the
Department of Science and Technology of Jiangsu Province (JSTD); BK2012525
funded by the Jiangsu Natural Science Foundation (JNSF); and HRSS2012-258 from
the Ministry of Human Resource and Social Security, China, in addition to support
from a research contract #31010300010339 from Nanjing First Hospital, China
(all to Dr. Xie).
STUDY QUESTIONS
1. What is the gold standard of current drug therapy in patient care?
2. Which causes are associated with the rapid increase of healthcare spending?
3. Optimal drug therapy is generally required to be
a. More effective
b. Less costly
c. Relatively safe
d. All of the above
4. Pharmacogenomics cannot be assumed to be cost-effective for a certain
pharmacogenomic intervention if there is no
a. Clinical validity
b. Clinical utility
c. Economic evaluation
d. All of the above
5. Why can’t all patients benefit from all medications cost-effectively?
6. The outcome measured for CEA is
a. Quality-adjusted life year (QALY) gained
b. Quality of life-adjusted life expectancy
c. The number of deaths averted
d. The number of the severe medical events avoided
e. All of the above
7. What is the outcome measured for CUA?