{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T14:16:38Z","timestamp":1783433798212,"version":"3.54.6"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Pharmacogenomic testing can optimize drug efficacy and minimize adverse effects. <jats:italic toggle=\"yes\">CYP3A5<\/jats:italic> polymorphisms affect the metabolism of tacrolimus. We sought to estimate the budget impact of preemptive pharmacogenomic testing for <jats:italic toggle=\"yes\">CYP3A5<\/jats:italic> in pediatric heart transplantation patients from an institutional perspective.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A decision tree was constructed to estimate the budget impact of pediatric heart transplant patients (age \u226418 years) initiated on tacrolimus with and without <jats:italic toggle=\"yes\">CYP3A5<\/jats:italic> pharmacogenomic testing. The budget impact of preemptive pharmacogenomic testing versus no pharmacogenomic testing was calculated. One-way sensitivity analysis and alternative analyses were conducted to assess the robustness of results to changes in model parameters.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>\n                                 <jats:italic toggle=\"yes\">CYP3A5<\/jats:italic> genotype-guided dosing provided savings of up to $17 225 per patient compared to standard dosing. These savings decreased to $11 759 when using another institution\u2019s data for the standard-dosing group. The time to achieve therapeutic concentration in the poor metabolizer genotype-guided dosing group had the largest impact on cost savings while the cost of the pharmacogenetic test had the smallest impact on cost savings.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Implementing <jats:italic toggle=\"yes\">CYP3A5<\/jats:italic> testing could save $17 225 per pediatric heart transplant patient receiving tacrolimus. As pharmacogenomic testing becomes more widespread, institutions should track resource requirements and outcomes to determine the best implementation policies going forward.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/fpc.0000000000000549","type":"journal-article","created":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T14:00:47Z","timestamp":1730210447000},"page":"81-86","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["CYP3A5 pharmacogenetic testing for tacrolimus in pediatric heart transplant patients: a budget impact analysis"],"prefix":"10.1097","volume":"35","author":[{"given":"Jiaqi","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Alfred E. Mann School of Pharmacy, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy L.","family":"Pasternak","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of Michigan, College of Pharmacy, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simran","family":"Maggo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Bernard J. Dunn School of Pharmacy, Shenandoah University, Winchester, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rochelle","family":"Mindanao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny Q.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Personalized Care Program, Department of Pathology, Children\u2019s Hospital Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia L.","family":"Gong","sequence":"additional","affiliation":[{"name":"Fetal and Neonatal Institute, Division of Neonatology, Department of Pediatrics, Children\u2019s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,10,29]]},"reference":[{"key":"R1-20250102","doi-asserted-by":"crossref","first-page":"3858","DOI":"10.1161\/01.CIR.0000150332.42276.69","article-title":"Drug therapy in the heart transplant recipient: part II: immunosuppressive drugs.","volume":"110","author":"Lindenfeld","year":"2004","journal-title":"Circulation"},{"key":"R2-20250102","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/cpt.113","article-title":"Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for CYP3A5 genotype and tacrolimus dosing.","volume":"98","author":"Birdwell","year":"2015","journal-title":"Clin Pharmacol Ther"},{"key":"R3-20250102","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.healun.2005.09.011","article-title":"Ten- and 20-year survivors of pediatric orthotopic heart 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