Currently, a population with a given disease generally receives the same therapy for all patients. Pharmacogenomics will change this ‘one-size-fits-all’ approach to drug treatments.
Konstantinos Lazaridis, M.D., Eric Matey, Pharm.D., R.Ph., and Jeffrey Bishop, Pharm.D., M.S., B.C.P.P., are expecting a future practice reality in which clinicians will have every patient’s pharmacogenetic information at their fingertips in the electronic health record (EHR). Adverse reactions to drugs will be avoided, and medications will work better as drugs will be matched to a patient’s genetic makeup.
At Individualizing Medicine 2016: Advancing Care Through Genomics, Dr. Lazaridis of Mayo Clinic moderated a session called “Pharmacogenomics and Your Practice.” This breakout session of the conference examined the integration of pharmacogenomics with the practice, and the future potential. This session featured Dr. Bishop of University of Minnesota, and Dr. Matey of Mayo Clinic Center for Individualized Medicine.
Pharmacogenomics is increasingly becoming a part of today’s medical practice. However, there are still some hurdles to overcome. For patients, the most important factor is cost. Gene panels can cost up to $3,000 currently, which insurance companies may not cover. However, Dr. Matey explains that prices are coming down significantly at a few hundred dollars per testing that can interpret the metabolism of about two hundred commonly prescribed drugs, and health care institutions will adopt affordable testing as common practice. Cost, as noted by Dr. Lazaridis, would soon be an issue of the past.
“Preemptive testing will become the order of the day when price is no longer an issue,” says Dr. Matey. He says he hopes in the future clinicians will have a dynamic tool where pharmacogenomic results will come in, be interpreted, and then show the appropriate prescription options.
“Instead of treating a population based on population information, we’re now able to further personalize or make our treatments more precise,” says Dr. Bishop.
Dr. Bishop explains that an evaluation of genetic information completed early in life is meaningful throughout the lifetime of a patient because DNA sequences do not change. The RIGHT study, done at Mayo Clinic, shows that 99 percent of all patients studied had some sort of genetic variant that impacts the way the body processes common medications. This leads to many patients experiencing adverse reactions to medications that are supposed to help them.
Currently, pharmacogenomic testing is used as a reactive strategy, in order to find out the cause of a problem. “I am a firm believer of preemptive Pharmacogenomics,” says Dr. Lazaridis. “This will revolutionize medical practice and improve the treatment of patients.”
Dr. Lazaridis predicts that preemptive testing will be a reality in the future: every patient will receive a pharmacogenomic test during his or her first appointment at the clinic. Their pharmacogenetic information will appear in the EHR and adverse reactions to medications will be prevented.
During the session, both Dr. Bishop and Dr. Matey described cases where patients had struggled with uncomfortable side effects from medications for years before finding the cause and the solution through pharmacogenomic testing. Some of those patients either could not metabolize certain medications, leading to a build-up or toxicity, or they metabolized them too quickly, which rendered the drugs ineffective.
Dr. Matey explained that you don’t have to be a pharmacist to help your patients with pharmacogenomic problems. However, having a pharmacist partner might be beneficial in some cases.
Dr. Matey remarks, “Pharmacogenomics is something that affects almost everyone.”
If you are interested in learning more or incorporating pharmacogenomics into your practice, visit the Pharmacogenomic Profile Service. Please note that within the next few months, Mayo Clinic expects to offer a more affordable option to patients on the Rochester campus. Arizona and Florida campuses are currently building out their Pharmacogenomic Profile service, and it may not be available for patients at this time.
The Mayo Clinic Center for Individualized Medicine hosted the conference with support from the Satter Foundation.
You’ll want to save the date for next year’s Individualizing Medicine Conference. It will be held Oct. 9 - 11, 2017.
Tags: #Dr. Jeffrey Bishop, #drug-gene reactions, #preemptive pharmacogenomics, center for individualized medicine, Dr. Eric Matey, Dr. Konstantinos Lazaridis, mayo clinic, PGx, pharmacogenomics, Uncategorized