Therapeutic drug monitoring · 2025
Economic Evaluation of Therapeutic Drug Monitoring and Precision Dosing in Pediatrics: A Short Communication.
СтатьяНазвание и аннотация: Перевод в очереди
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Lechuga-Noa Víctor E, Taboada Guillermo Federico, Cáceres Guido Paulo
Аннотация
BACKGROUND: This scoping review evaluates the economic impact of therapeutic drug monitoring (TDM) and model-informed precision dosing (MIPD), incorporating clinical pharmacokinetics principles in pediatric populations.
METHODS: This study followed the PRISMA-ScR guidelines. From 1057 articles identified, 8 met inclusion criteria (5 retrospective studies and 3 Markov-based simulations) focusing on the following drugs: PEG-asparaginase, valproic acid, carbamazepine, phenytoin, phenobarbital, vancomycin, adalimumab, tobramycin, cyclosporine, and perampanel.
RESULTS: Most studies reported cost savings or improved cost-effectiveness with TDM-MIPD strategies. However, analyses were limited to direct medical costs, with little consideration of indirect or societal costs. Also, methodological heterogeneity limited direct comparisons.
CONCLUSIONS: The lack of standardized methodologies and economic endpoints, along with potential underreporting of negative findings, restricts the generalizability of conclusions. Nevertheless, current evidence supports TDM-MIPD as a potentially cost-effective approach in pediatric pharmacotherapy.
METHODS: This study followed the PRISMA-ScR guidelines. From 1057 articles identified, 8 met inclusion criteria (5 retrospective studies and 3 Markov-based simulations) focusing on the following drugs: PEG-asparaginase, valproic acid, carbamazepine, phenytoin, phenobarbital, vancomycin, adalimumab, tobramycin, cyclosporine, and perampanel.
RESULTS: Most studies reported cost savings or improved cost-effectiveness with TDM-MIPD strategies. However, analyses were limited to direct medical costs, with little consideration of indirect or societal costs. Also, methodological heterogeneity limited direct comparisons.
CONCLUSIONS: The lack of standardized methodologies and economic endpoints, along with potential underreporting of negative findings, restricts the generalizability of conclusions. Nevertheless, current evidence supports TDM-MIPD as a potentially cost-effective approach in pediatric pharmacotherapy.