Interventions:
The rationale for the choice of comparators was explicitly reported. The authors compared pharmacotherapies, which were commonly used in their setting, with a strategy in which the choice of treatment depended on genetic testing.
Effectiveness/benefits:
The effectiveness data were derived from published literature, but no systematic literature review was reported. The authors did not provide any details on their search methods or inclusion criteria. Only restricted information on the type and characteristics of the source studies was reported. The issue of heterogeneity among the data sources was not addressed. This lack of detail on the sources of the effectiveness data makes it impossible to make an objective assessment of the validity of the clinical data. Life-years are a common benefit measure and allow cross-disease comparisons to be made.
Costs:
The authors did not explicitly report the viewpoint of the economic analysis, but the categories of costs suggest that the perspective of the health service payer was adopted. A breakdown of cost items was provided and information on resource consumption was given. The sources of unit costs and the use of discounting were reported. The price year was not reported, and this will hinder reflation exercises.
Analysis and results:
The synthesis of costs and benefits was appropriately performed by means of an incremental analysis. The modelling was well described. The issue of uncertainty was investigated only using deterministic analysis. The results of the base-case and sensitivity analyses were well reported. The authors compared these results with those from other studies and highlighted the reasons for some differences. In addition they provided a balanced discussion on the limitations of their study, in particular in relation to the quality of the available data.
Concluding remarks:
Overall, the study was based on valid methodology, but the sources for the clinical data were not described in depth. The authors’ conclusions appear to be appropriate.
