Pharmacogenetic testing has become a popular addition to employee benefits packages, primarily because of its ability to inform personalized drug treatment, especially in mental health where it can be challenging to find an appropriate treatment and dosage that’s effective without causing side-effects.
Many patients end up trying multiple medications and dosages without achieving improved outcomes, said John Papastergiou, community pharmacist and assistant professor at the University of Toronto, during Benefits Canada‘s 2021 Mental Health Summit. “About 70 per cent of the testing that we do right now is in the mental-health space.”
To ensure a return on investment for pharmacogenetic testing, the process must be optimized to remove the barriers to adopting it in practice, he said. The first step is ensuring employees are aware of and have confidence in the test. “Community pharmacists are ideally suited to offer this service,” noted Papastergiou, because they can identify who would benefit from the test and explain the potential benefits.
Speed is key, especially in mental health, he added. “If we can get patients on the right medication quicker, they will have fewer side-effects, better adherence and outcomes.”
When choosing a pharmacogenetic testing partner, it’s important for payers to consider the turnaround time. Some vendors have a step that requires them to review the results first. According to Papastergiou, an easily accessible platform with easy-to-understand guidance can support the community pharmacist to make recommendations to the prescribing physician and patient in a faster and more efficient manner.
“It’s also important to have confidence in the recommendations that are being made,” he said, recommending that payers choose providers with accredited laboratories that offer tests developed and maintained by qualified genetic experts. In addition, as the evidence regarding drug and gene interactions grow, it’s important that providers regularly update test results and reports to incorporate new findings.
Unfortunately, “some insurers will specify which vendor patients have to deal with. I think it should be equitable,” said Papastergiou, suggesting payers allow patients access to the pharmacogenetic test that’s recommended by their pharmacist.
An anonymous patient story that was shared during the session described how they had taken 10 different drugs at different doses over a 15-year period with little symptom relief. However, a lot of side-effects and withdrawal symptoms impeded the patient’s ability to be fully present in their job. The ongoing struggles resulted in the patient being on and off work for years.
Their pharmacist suggested they take a pharmacogenetic test, which generated “startling results that were overwhelming and extremely timely,” they said. “All of a sudden everything started to make sense. All the drugs I’d failed on in the past were not recommended options for me based on my genetics and could have been avoided if testing had been done sooner.”
Read more coverage of the 2021 Mental Health Summit.