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Pharmacogenomics: Drug-Gene Testing for Personalized Treatments
- March 20, 2019
- Amber Specialty Pharmacy
- Amber Specialty Pharmacy
When patients are newly diagnosed with a specific condition, doctors must often try several drug therapies before settling on one that effectively manages the disease and its symptoms, while avoiding as many undesirable side effects as possible. A drug that works for one patient may not work for another.
One of the reasons for this variation is that a patient’s unique genes may affect how the body processes and responds to medications. Pharmacogenomics is the study of this relationship, and how to develop safe, effective drugs that are tailored to a person’s genetic makeup.
All Genes Vs. One Gene
Pharmacogenomics, which studies how all of the genes, or genome, can influence the response to a drug, is closely related to pharmacogenetics, which refers to how one single gene influences the response to a drug.
In healthcare, one major goal is personalized medicine, which means providing individualized treatment. In order to achieve this goal, one must predict the clinical outcome of different treatments in different patients. Pharmacogenomics is one of the core elements in personalized medicine. Pharmacists are uniquely qualified to play an essential role in the clinical implementation of pharmacogenomics, as inter-individual variability can cause differing medication responses, doses and side effects.
Patients can now undergo pharmacogenomics testing, in which a blood or saliva sample can help determine these factors. There are some limitations, however. One single pharmacogenomics test cannot be used to determine responses to all medications, not all medications have pharmacogenomics testing available and currently there are no pharmacogenomics tests for most over-the-counter drugs.
Pharmacogenomics is a relatively new area of study, but it is rapidly gaining support among health care professionals, including those in the pharmaceutical industry. National pharmacy organizations support a pharmacist’s role in applying pharmacogenomics to patient care. The American Pharmacists Association (APhA) issued a report supporting the development and integration of pharmacogenomics into medication therapy management, and The American Society of Health Systems Pharmacists (ASHP) published a policy statement enforcing a need for all pharmacists to gain basic competence in pharmacogenomics.
Testing Costs and Coverage
Pharmacogenomics does not just yield better clinical outcomes, but can also offer considerable savings to health systems. Recent publications have demonstrated cost-effectiveness of pharmacogenetic-guided medication management in several clinical specialties including, psychiatry, cardiology, neurology and primary care.
The cost of testing varies depending on which test is done and what your insurance policy covers. Health care providers who offer this service should be able to provide an estimate. If you are concerned about cost, be sure to contact your insurance provider before testing.
A federal law called the Genetic Information Nondiscrimination Act (GINA) protects you against health insurance companies using your genetic information to discriminate against you. This protection does not extend to life insurance, disability insurance or long-term care insurance companies, but some state laws do address this.
Pharmacogenomics is a relatively new field of study, but is rapidly leading to advancements in drug therapies. Talk to your doctor if you are curious about getting tested, and they will help determine if it would be appropriate for your condition and treatment.