Economic Evaluation of Therapeutic Drug Monitoring and Precision Dosing in Pediatrics: A Short Communication.

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.