• Vol. 43 No. 4, 235–237
  • 15 April 2014

Informing the Design of a Discrete Choice Experiment for Evaluating Warfarin Pharmacogenetic Testing Among Mandarin-speaking Chinese Warfarin Patients in Singapore: A Mixed Methods Analysis

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Specific genetic variants have a substantial effect on warfarin dose response but warfarin pharmacogenetic testing (WPGT) is still not routine clinical practice. Apart from clinical validity, economics, social, ethical and legal implications are also important aspects in the implementation of WPGT. Several studies have revealed high interest in pharmacogenetic testing (PGT) but also concerns over privacy, confidentiality and cost. However, these studies were all conducted in non-Asian populations, whom may have different perceptions and attitudes towards PGT from Asians due to cultural differences. On the economic front, the cost-effectiveness of WPGT is inconclusive and no cost-benefit analyses, where willingness-to-pay (WTP) is used to value health benefits in monetary terms have been done. The discrete choice experiment (DCE) methodology is an increasingly popular method not just for generating health preferences in healthcare decision-making, but also to elicit WTP. In a DCE, individuals are asked to state their preferences between alternative choice sets with each choice set defined by a number of attributes, which may include cost and efficacy in the context of WPGT. To the best of our knowledge, there has been no preference study for WPGT in any population internationally.

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