Economic effectiveness of pharmacogenomics-guided prescribing for psychiatric disorders: a systematic review and meta-analysis

CYP2D6, CYP2C19 (SSRIs, SNRIs, TCAs)

Preemptive CYP2D6/CYP2C19 genotyping before antidepressant initiation → reduction of sequential trials, ADRs and hospitalizations; assessment of economic efficiency (cost-utility, incremental net benefit)

Systematic review and meta-analysis of PGx genotyping economic efficiency in psychiatric disorders. From 1,271 references, 17 studies were included. 88% of studies favor genotype-guided prescribing. The meta-analysis produces a pooled incremental net benefit (INB) of £1,623 (95% CI: -£117 to £3,363; p=0.07; I²=100%), positive but non-significant due to very high heterogeneity, reflecting non-standardization of economic models.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

In a context where the first antidepressant failure rate reaches 40-50%, this meta-analysis provides a moderate but real economic argument for preemptive CYP2D6/CYP2C19 genotyping. The non-significance reflects methodological heterogeneity across studies, not the absence of an effect. Standardization of economic evaluation methods is the essential prerequisite for generalization.

Analysis by Dr Thibaut Benquey

meta-analysis of 17 studies (complete systematic review) +2; psychiatric CPIC Level A +2; economic argument for generalization +2; Pharmacogenomics J +1; 88% favorable studies +1