%0 Journal Article %A Tima Mohammadi %A Mohsen Sadatsafavi %A Chris Carlsten %T The economics of precision health: preventing air pollution-induced exacerbation in asthma %D 2021 %R 10.1183/23120541.00790-2020 %J ERJ Open Research %P 00790-2020 %X Background The demonstrable value of precision medicine, in the context of common environmental exposures, has scarcely been explored. This study evaluated the cost-effectiveness of a preventive personalised intervention to reduce the adverse effect of air pollution in the context of asthma.Methods A decision-analytic model was used to conduct a cost-utility analysis of prevention interventions in case of acute exposure to air pollution in mild asthma. Three different strategies, as follows, were compared: no preventive intervention, precision health strategy based on information from genotype testing – followed with treating high-risk patients, and prescribing additional medication to all mild asthmatics as a preventive intervention. The costs and quality-adjusted life years (QALYs) in the base case and alternative scenarios were obtained through probabilistic analysis.Results The results showed that the precision prevention intervention (anticipatory intervention for asthmatics, guided by relevant genetic abnormality, in the face of acute air pollution) is a cost-effective strategy compared to no such intervention, with an incremental cost-effectiveness ratio of $49 555 per QALY. Furthermore, this strategy is a dominant strategy compared to an intervention that prescribes medication indiscriminately to all asthmatics.Conclusion The incorporation of genomic testing, to stratify risk of asthmatics to pollution-driven exacerbations, and then tailoring a preventive intervention accordingly, may be cost-effective relative to untailored methods. These results lend plausibility to the use of precision medicine for limiting asthma exacerbation in the context of air pollution and, potentially, other exposures.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Mohammadi has nothing to disclose.Conflict of interest: Dr. Sadatsafavi has nothing to disclose.Conflict of interest: Dr. Carlsten has nothing to disclose. %U https://openres.ersjournals.com/content/erjor/early/2021/01/14/23120541.00790-2020.full.pdf