{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:12:22Z","timestamp":1790745142475,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,7,29]],"date-time":"2013-07-29T00:00:00Z","timestamp":1375056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004396","name":"Thailand Research Fund","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004396","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Senior Research Scholar on Health Technology Assessment","award":["RTA5580010"],"award-info":[{"award-number":["RTA5580010"]}]},{"name":"National Health Security Office"},{"DOI":"10.13039\/501100009061","name":"Thai Health Promotion Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009061","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Health System Research Institute"},{"name":"Bureau of Health Policy and Strategy"},{"name":"Ministry of Public Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2013,9]]},"abstract":"Summary<\/jats:title>Purpose<\/jats:title>There is strong evidence of an association between the presence of the human leukocyte antigen (HLA<\/jats:styled-content>)\u2010B*15:02 and two severe adverse drug reactions\u2014S<\/jats:styled-content>tevens\u2010J<\/jats:styled-content>ohnson syndrome (SJS<\/jats:styled-content>) and toxic epidermal necrolysis (TEN<\/jats:styled-content>)\u2014in patients taking carbamazepine (CBZ<\/jats:styled-content>), a common treatment for patients with epilepsy and neuropathic pain. As a result, there are calls for all patients that are due to undergoCBZ<\/jats:styled-content>therapy to be screened for this genetic marker before commencing their therapy. This study aims to determine the value for money ofHLA<\/jats:styled-content>\u2010B*15:02 screening compared to the following: (1) administeringCBZ<\/jats:styled-content>therapy without conducting patient screening, and (2) not prescribingCBZ<\/jats:styled-content>but alternative drugs that are less likely to result in severe reactions, but that come at a higher cost.<\/jats:p><\/jats:sec>Method<\/jats:title>An economic evaluation was carried out by using a decision tree and Markov models to examine the cost\u2010utility of providingHLA<\/jats:styled-content>\u2010B*15:02 screening for all patients with either newly diagnosed epilepsy or neuropathic pain in the Thai setting. All transitional probabilities were derived from the national and international literature. The majority of the data on direct medical care costs were collected from 10 community, provincial, and regional hospitals throughout Thailand. Direct non\u2010medical cost and health\u2010related quality of life (HRQ<\/jats:styled-content>oL) data were obtained from interviews that were conducted with 33 patients, some of whom had experienced severe drug reactions.<\/jats:p><\/jats:sec>Key Findings<\/jats:title>The incremental cost\u2010effectiveness ratio (ICER<\/jats:styled-content>) of adopting a universalHLA<\/jats:styled-content>\u2010B*15:02 screening policy was estimated at 222,000Thai baht, THB<\/jats:styled-content>\/quality\u2010adjusted life year (QALY<\/jats:styled-content>) gained for epilepsy patients and 130,000THB<\/jats:styled-content>\/QALY<\/jats:styled-content>gained for patients with neuropathic pain. Furthermore, we found that 343 patients need to be tested forHLA<\/jats:styled-content>\u2010B*15:02 allele to prevent one case ofSJS<\/jats:styled-content>\/TEN<\/jats:styled-content>.<\/jats:p><\/jats:sec>Significance<\/jats:title>UniversalHLA<\/jats:styled-content>\u2010B*15:02 screening represents good value for the money in terms of preventingSJS<\/jats:styled-content>\/TEN<\/jats:styled-content>inCBZ<\/jats:styled-content>\u2010treated patients with neuropathic pain at the Thai ceiling ratio of 120,000THB<\/jats:styled-content>\/QALY<\/jats:styled-content>gained. However, the prevalence ofCBZ<\/jats:styled-content>\u2010inducedSJS<\/jats:styled-content>\/TEN<\/jats:styled-content>in the Thai population and the positive predictive value (PPV<\/jats:styled-content>) are major factors that influence the cost\u2010effectiveness ofHLA<\/jats:styled-content>\u2010B*15:02 screening. Therefore, an active surveillance system to make a more accurate assessment of the prevalenceCBZ<\/jats:styled-content>\u2010inducedSJS<\/jats:styled-content>\/TEN<\/jats:styled-content>in the Thai population would enhance the generalizability of the results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.12325","type":"journal-article","created":{"date-parts":[[2013,7,29]],"date-time":"2013-07-29T12:38:24Z","timestamp":1375101504000},"page":"1628-1638","source":"Crossref","is-referenced-by-count":80,"title":["Economic evaluation ofHLA<\/scp>\u2010B*15:02 screening for carbamazepine\u2010induced severe adverse drug reactions inT<\/scp>hailand"],"prefix":"10.1111","volume":"54","author":[{"given":"Waranya","family":"Rattanavipapong","sequence":"first","affiliation":[{"name":"Health Intervention and Technology Assessment Program (HITAP) Nonthaburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanunya","family":"Koopitakkajorn","sequence":"additional","affiliation":[{"name":"Health Intervention and Technology Assessment Program (HITAP) Nonthaburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naiyana","family":"Praditsitthikorn","sequence":"additional","affiliation":[{"name":"Health Intervention and Technology Assessment Program (HITAP) Nonthaburi Thailand"},{"name":"Bureau of AIDS TB and STIs, Department of Disease Control Ministry of Public Health Nonthaburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surakameth","family":"Mahasirimongkol","sequence":"additional","affiliation":[{"name":"The National Institute of Health Department of Medical Sciences Ministry of Public Health Nonthaburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yot","family":"Teerawattananon","sequence":"additional","affiliation":[{"name":"Health Intervention and Technology Assessment Program (HITAP) Nonthaburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,7,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200017050-00006"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198526629.001.0001","volume-title":"Decision modelling for health economic evaluation","author":"Briggs A","year":"2006"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8510(96)00822-6"},{"key":"e_1_2_7_5_1","volume-title":"Report for consumer price index of THAILAND YEAR 2011 BASE YEAR 2007","author":"Bureau of Trade and Economic Indices","year":"2011"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/92.3.177"},{"key":"e_1_2_7_7_1","volume-title":"Reference price database","author":"Center of Essential Information for All Health Officers","year":"2011"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/FPC.0b013e32831d0faf"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.4172\/2153\u20100645.S6\u2010001"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009717"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/428486a"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31826aac73"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2004.01.005"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-5-39"},{"key":"e_1_2_7_15_1","volume-title":"Genetic: SJS\/TEN in Thais","author":"Health Product Vigilance Center","year":"2011"},{"key":"e_1_2_7_16_1","volume-title":"Report of adverse drug reaction 2006\u20132011","author":"Health Product Vigilance Center","year":"2011"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2010.11.020"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0409500102"},{"key":"e_1_2_7_19_1","unstructured":"KankeawlarP PhurmsuwanA. 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