OBJECTIVES

: To compare polymerase chain reaction (PCR)-sequencing method and real time PCR (rtPCR) with HybProbe® fluorescent probes method, using a cost minimization analysis to determine the lower-cost method for the intentification of genetic polymorphisms in clinical practice.

METHODS

: The cost-minimization calculator was designed using Excel®2003. Direct cost derived from the SNP(Simple Nucleotide Polymorphism) determination were compared between two methods:

Method1: Amplification by PCR and sequencing

Method2: rtPCR and HybProbe® with allele-specific fluorescent probes determination.

Reigistered variables for sensitivity analysis were: SNPs to be determined, monthly samples and sequencing-price.

Base case was performed with: 22 monthly patients, with 34 SNPs by patient, during two years and a sequencing cost of 5€ per determination.

The sensitivity analysis was done with: cost sequencing between 2-7 €; number of patients between 5 and 40; and a number of SNP determinations between 5 and 60.

RESULTS

: The base case would involve a cost of: 101,944.5€ for method 1(212.4€/ patient) and 20,118.6 € for method 2 (41.9€ / patient ).

The sensitivity analysis showed that a reduction of 60% in the sequencing cost would reduce the method 2 cost to 52,984.5€.

To reduce SNPs to 5: method 1: