The Problem

Annual costs of non-optimized prescription drug therapy, in terms of morbidity and mortality, has been estimated at over $528 billion dollars, where each therapeutic failure costs approximately $2,500 and each drug related adverse reaction costs roughly $2,600.

Reference: Watanabe JH, McInnis T, Hirsch JD. Cost of Prescription Drug-Related Morbidity and Mortality. Ann Pharmacother. 2018 Sep;52(9):829-837. doi: 10.1177/1060028018765159.

Cost-effectiveness of a pharmacogenetic test to guide treatment for major depressive disorder

Data from previous studies was used to model cost-effectiveness of PGx-guided medication management vs. standard of care (SOC) for major depressive disorder treatment. After undergoing PGx testing, providers followed-up with patients at four, eight and 12 weeks. Outcomes evaluated were total costs (direct and indirect), quality-adjusted life years (QALYs) and suicide rates.

• Reduced costs: The model predicted total cost savings of $2,918 in direct and $1,680 in indirect costs in PGx-guided treatment group when compared with SOC.

• Better patient outcomes: The model predicted lower probability of death from suicide (0.328% vs. 0.351%) and higher QALYs (2.07 vs. 1.97) for the PGx group when compared with patients receiving SOC. 

For a suicide death to be prevented, approximately 4,300 patients would need to be tested. (p-values not reported in this study)

Reference: Groessl EJ, Tally SR, Hillery N, Maciel A, Garces JA. Cost-Effectiveness of a Pharmacogenetic Test to Guide Treatment for Major Depressive Disorder. J Manag Care Spec Pharm. 2018;24(8):726-734. doi:10.18553/jmcp.2018.24.8.726

Cost avoidance related to a pharmacist-led pharmacogenomics service for the program of all-inclusive care for the elderly

The team in this study consisted of prescribers, pharmacists, patients and residents. Prescribers referred patients to a clinical pharmacist for comprehensive medication management due to inadequate response to prescribed drugs. If necessary, pharmacogenomic tests were run and the pharmacists provided prescribers dosing recommendations based on these results.

• Reduced costs: Estimated cost avoidance when the study recommendation rate (70.5%) was utilized was $162,031. Cost avoidance with a 100% acceptance rate was $233,945. The mean cost avoidance per actionable drug–gene pair was $1,983 per participant. 

Reference: Bain KT, Knowlton CH, Matos A. Cost avoidance related to a pharmacist-led pharmacogenomics service for the Program of All-inclusive Care for the Elderly. Pharmacogenomics. 2020;21(10):651-661.

After discharge from the inpatient acute care setting, the use of PGx helped decrease emergency department visits and hospital readmissions at 60 days, translating to nearly $4,400 savings per patient.

Reference: Elliott LS, Henderson JC, Neradilek MB, Moyer NA, Ashcraft KC, Thirumaran RK. Clinical impact of pharmacogenetic profiling with a clinical decision support tool in polypharmacy home health patients: A prospective pilot randomized controlled trial. PLoS One. 2017 Feb 2;12(2):e0170905.

In a study of polypharmacy in a group of retirees, PGx with clinical decision support resulted in a per-patient-per-month cost savings of approximately $220.30.

When considering the covered lives (N=5288) in the health plan and the 32-month timeframe, direct medical cost savings exceeded $37 million dollars. 

A health resource utilization evaluation showed a decrease in outpatient medical visits, emergency department visits, and inpatient hospital days.

Reference: Jarvis JP, Peter AP, Keogh M, Baldasare V, Beanland GM, Wilkerson ZT, Kradel S, Shaman JA. RealWorld Impact of a pharmacogenomics-Enriched Comprehensive Medication Management Program. J Pers Med. 2022 Mar 8;12(3):421. doi: 10.3390/jpm12030421.

In precision medicine, there are a myriad of decisions and actions associated with implementing a pharmacogenomics testing program. 

From engaging the patient and obtaining informed consent to partnering with a qualified laboratory to communicating actionable results in a concise easy-to-understand way, it takes the personal touch of a MedGenyx pharmacist to connect those dots and manage the big picture. 

Add a PGx test to your suite of options and with the medication expertise of a MedGenyx pharmacist, become a true health partner to your providers / members / employees.  

Pharmacogenomics testing can equip your providers with a tool that enhances clinical decision making. The pharmacists at MedGenyx can bring dedicated support to your new or existing PGx program with interpretation assistance, with clinical consults and recommendations.

Pharmacogenomics testing can be integrated into your efforts to improve clinical outcomes and manage costs. It is an innovative solution to differentiate your plan.

Your members / employees' health begins in their genes. By understanding their unique medication metabolizer status, they will have the power to get the right medication at the right dose and at the right time!

Residents in a care home setting are among the most likely to benefit from pharmacogenomics testing.

These patients have the highest incidence of adverse drug reactions and adverse drug events. PGx testing can also support a deprescribing initiative to help mitigate polypharmacy.