The effect of CYP2C19 gene Polymorphism and cost-result analysis in stroke events observed after clopidogrel use

Stroke due to damage to the central nervous system is one of the most important causes of death in the world. Clopidogrel, one of the traditional treatments of stroke which is a costly disease, is an antiplatelet-specific pro-drug. In order to be activated of klopidogrel, it must be metabolized with members of the cytochrome P450 (CYP) enzyme family. Differences in enzyme activity with the effect of polymorphism also cause different treatment responses among individuals. Polymorphism in drug-metabolizing enzymes may result in adverse events occurring due to inadequate response to treatment of patients and changes in drug action. Such situations pose a significant burden on countries' health budgets. In this study, a decision tree model was created for different treatment responses to clopidogrel and cost-consequences analysis was performed for the determination of CYP2C19*2 gene polymorphism. According to the results of our study, CYP2C19*2 gene polymorphism was investigated as a cost-effective approach in patients using clopidogrel. This study is the first study to investigate the effect of CYP2C19*2 gene polymorphism and cost-effect analysis on stroke events observed after clopidogrel use on Turkish population. Our results are guiding the implementation of the personalized treatment approach in the clinics for the competent decision makers for health payments.