One of the most frustrating aspects of healthcare for physicians and patients alike is when the prescribed drugs don’t work.
When that happens, patients end up making several trips to their physician for the same problem, spending money on multiple prescriptions and having an unfavorable care experience. For doctors, ineffective medicines can add pressure to their scheduling because patients have to return. It also can diminish the patient’s willingness to adhere to a prescription schedule.
Dr. Nicole Umberger, Technical Director of Molecular Pathology for LifeBrite Laboratories, believes molecular pathology testing can help eliminate most of these frustrations.
Molecular pathology testing, among other things, uses your genetics to determine which medications will work best for you. With a cheek swab, LifeBrite extracts a DNA sample and then runs it on an instrument to assess your genotype. Those results help lab technicians understand how a person metabolizes different drugs.
Pharmacogenetic guidance and compliance
Genetic testing to optimize drug treatments is gaining popularity. Consider this: American physicians on average prescribe more than 4 billion drugs annually, and 38-75 percent of those drugs don’t work for the person taking the medication.
“You want your patient to get therapeutic benefit from the drugs you prescribe. You want them to be compliant as well,” said Dr. Umberger. “If they take a medication and get splitting headaches, they likely won’t continue to take it. If you start them on a drug that works for them, you are likely to get better compliance.”
Plus, pinpointing the best prescription early in the treatment process can save patients money. A 2015 study published in Current Medical Research Opinion found that patients who underwent and followed pharmacogenetic testing guidance saved an average of $1,035 per year. When the testing recommended a switch to a compatible medication, the average cost savings increased to $2,774 per year.
How does pharmacogenetics work?
In traditional clinical trials for medication, researchers determine the average risks, adverse effects, recommended dosage, and other safety and usage information. The results are based on the outcomes of a trial population through several phases of testing.
Clinical trials haven’t traditionally taken into account how certain genetic variations might change the way a patient responds to a drug, said Dr. Umberger. However, the FDA’s Genomics and Targeted Therapy Group now works to apply pharmacogenomics and biomarkers in drug development.
“This highlights the importance of knowing one’s genotype and metabolizer phenotype,” Dr. Umberger said. “As more drugs come to market, there is a greater chance they will come with pharmacogenetic guidance. Therefore, while someone may need to know about their genotype for one medication today, their genotype could be relevant for other medications in the future.”
Scientists know multiple factors influence a person’s drug response. “For example, genetic variations in the cytochrome P450 (CYP) genes can influence how a drug is metabolized. This means one person may metabolize a drug well, while another person with a different genetic variant may not metabolize the same drug at all,” Dr. Umberger said.
According to a 2017 study published in Genome Medicine, genetic testing to find these variants could improve medication effectiveness for a majority of people. The study found that four out of five patients carry at least one genetic variant that could affect targets for commonly prescribed drugs.
Molecular pathology testing for precision guidance
LifeBrite Laboratories offers genetic testing for precision guidance for medications used to manage cardiovascular, mental disorders, pain management, cancer treatment, diabetes, gastrointestinal conditions, infectious disease, immune disorders and urological conditions.
Even though mail-order genetic testing may be tempting to some patients, Dr. Umberger stressed that LifeBrite’s genetic testing is more sophisticated.
“The problem with most direct-to-consumer genetic testing is they don’t give the same level of detail and don’t look at as many variants. Some people may have a gene duplication which can change their metabolizer phenotype and, therefore, medication guidance, a factor that is not typically captured by some of the limited offerings of most direct-to-consumer products currently on the market,” she said.
When a physician orders a pharmacogenetic report for a patient from LifeBrite, the physician receives a detailed but easy-to-follow report that takes into account a patient’s demographics, current medications and any indications based on the genetic testing results. It details potentially impacted drugs, dosing guidance and testing details.
“The therapeutic benefits of pharmacogenetic testing are well established and have strong clinical utility. For patients on or considering drugs with pharmacogenetic guidance, results from this test can improve patient satisfaction and save them money in the long term,” said Dr. Umberger.
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