Pharmacogenomics: Turning the Tide Toward Making PGx Standard of Care

With the recent launch of 988, a three-digit suicide and crisis hotline modeled after 911, more attention than ever is being paid to mental health and the need for effective care.

In 2019, 50 million American adults were living with a mental illness [1]. Those numbers have since increased, due in part to the COVID-19 pandemic. “Anyone in the mental health space can see and probably knows that things are getting worse and not better, especially in our youth population,” said Daniel Dowd, PharmD, Senior Vice President of Medical Affairs at Genomind, during a recent webinar with GenomeWeb.

Watch the webinar.

In his presentation, Dowd explored the potential of pharmacogenomics (PGx) to improve mental healthcare and advance precision medicine more broadly by ensuring patients are prescribed the right dose of the right medication at the right time.

How PGx fits into the medication management puzzle

PGx testing can help better predict drug safety and tolerability, in turn working to improve medication adherence. Many patients with psychiatric conditions are prescribed pharmaceuticals, but medication non-adherence poses a major risk. According to Dowd, up to 50% of patients with chronic illnesses may be non-adherent to medication regimes.

In addition, by providing meaningful data on a patient’s responses to medications based on their genetic profile, PGx testing can help prevent adverse drug reactions (ADRs), which lead to 3.2 million hospital and emergency room visits per year in the United States [2]. ADRs are a significant concern in the long-term care space, where patients are at a higher risk due to the number of medications they take. Data presented by Dowd shows that up to 60% of people in nursing homes experience ADRs.

“We recognize that one size does not fit all,” said Dowd during the webinar. “All of the dosing that you see in FDA labels are based on population averages, but there is tremendous variability within these averages. What pharmacogenomics tries to do is isolate some of that variability within these averages so we can provide more patient-specific dosing and more patient-specific drug selection.”

Increasing support for PGx testing

Dowd also outlined real-world studies that support the clinical and economic benefits of utilizing PGx testing in healthcare. One meta-analysis found that patients who receive PGx testing were 70% more likely to be in remission from depression [3]. Overwhelmingly, the examples shared by Dowd demonstrate that tested patients not only benefit physically but financially, with fewer hospital and emergency room visits.

Awareness of PGx is growing and in 2020, the U.S. Food and Drug Administration (FDA) announced a collaborative review of the science supporting PGx testing [4]. As the field continues to mature, even payers have taken notice. Medicare, the largest payer in the United States, deemed PGx to be “considered reasonable and necessary when the result of that test is necessary for the physician’s decision-making process regarding safely administering or dosing the drug.” [5]

As PGx testing becomes more common, standardization across the field has also improved thanks to guidelines from government agencies like the FDA and scientific consortiums, including CPIC, PharmKGB and PharmVar. In addition, primary literature provides an important source for updates on any new, novel drug-gene associations.

For Dowd, the future of PGx looks promising: “We’ve really reached an inflection point and I don’t know if it’s two years, five years, or ten years, but I think we are on the path to seeing pharmacogenomics start to become standard of care.”

To learn more about pharmacogenetic testing, its applications and evidence supporting its utilization, watch the free webinar on-demand.

For information on Thermo Fisher Scientific’s pharmacogenomic testing solutions, please visit https://www.thermofisher.com/pgx.

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