{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:45:15Z","timestamp":1787168715759,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T00:00:00Z","timestamp":1689120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      Despite the availability of newer antiseizure medications, carbamazepine (CBZ) remains the gold standard. However, patients of Asian ancestry are susceptible to CBZ\u2010related severe cutaneous adverse reactions. Universal\n                      <jats:italic>HLA\u2010B*15:02<\/jats:italic>\n                      screening is a promising intervention to address this. With the increasing recognition of integrating real\u2010world evidence in economic evaluations, the cost\u2010effectiveness of universal\n                      <jats:italic>HLA\u2010B*15:02<\/jats:italic>\n                      screening was assessed using available real\u2010world data in Malaysia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A hybrid model of a decision tree and Markov model was developed to evaluate 3 strategies for treating newly diagnosed epilepsy among adults: (i) CBZ initiation without\n                      <jats:italic>HLA\u2010B*15:02<\/jats:italic>\n                      screening (current practice); (ii) universal\n                      <jats:italic>HLA\u2010B*15:02<\/jats:italic>\n                      screening prior to CBZ initiation; and (iii) alternative prescribing without\n                      <jats:italic>HLA\u2010B*15:02<\/jats:italic>\n                      screening. The model was populated with real\u2010world inputs derived from the Malaysian population. From a societal perspective, base\u2010case analysis and sensitivity analyses estimated the costs and outcomes over a lifetime. Incremental cost\u2010effectiveness ratios were calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the base\u2010cases analysis, universal\n                      <jats:italic>HLA\u2010B*15:02<\/jats:italic>\n                      screening yielded the lowest total costs and the highest total quality\u2010adjusted life years (QALYs) gained. Compared with current practice, universal screening was less costly by USD100 and more effective by QALYs increase of 0.1306, while alternative prescribing resulted in 0.1383 QALYs loss at additional costs of USD332. The highest seizure remission rate (56%) was estimated for universal\n                      <jats:italic>HLA\u2010B*15:02<\/jats:italic>\n                      screening\n                      <jats:italic>vs<\/jats:italic>\n                      . current practice (54%) and alternative prescribing (48%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Our study suggests that universal\n                      <jats:italic>HLA\u2010B*15:02<\/jats:italic>\n                      screening is a cost\u2010effective intervention in Malaysia. With the demonstrated value of real\u2010world evidence in economic evaluations, more relevant standardization efforts should be emphasized to better inform decision\u2010making.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bcp.15818","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T07:50:00Z","timestamp":1686297000000},"page":"3340-3351","source":"Crossref","is-referenced-by-count":9,"title":["Integrating real\u2010world data in cost\u2010effectiveness analysis of universal\n                    <i>HLA\u2010B*15:02<\/i>\n                    screening in Malaysia"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0768-1844","authenticated-orcid":false,"given":"Huey Yi","family":"Chong","sequence":"first","affiliation":[{"name":"Cedar Healthcare Technology Research Centre Cardiff and Vale University Health Board  Cardiff 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