Pharmacogenomics is a branch of personalized precision medicine where a patient's medication and dosage are selected based on their individual genetic profile. Currently medications and dosages are selected for a patient based on factors such as age, weight, kidney/liver function, among other variables. However, beyond these variables prescribing is very one-size-fits-all.

 

Prescribers utilize established guidelines created from studying clinical trials of huge populations, and then set out on a prescribing odyssey with their patients. This often means trying several medications and experiencing several side effects, wasted time and wasted money that could often have been predicted by utilizing PGx. The information from a PGx panel will provide optimal safety and efficacy information that can greatly influence the success of many medication treatments.  

 

In recent years, the costs of obtaining a PGx panel have been significantly reduced. And there is growing evidence everyday that PGx can help guide medication selection to improve outcomes in the following therapies in particular:

• Mental health (anxiety, depression, psychosis, etc)

• Pain management

• Gastrointestinal 

• Cardiology 

• Oncology

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The FDA now contains drug label annotations regarding PGx testing for 382 drugs on the market, further reiterating the established importance of utilizing PGx testing.​

Comprehensive Medication Management is a patient-centered, systematic and coordinated method of drug selection where a prescriber and pharmacist coordinate drug therapy. It is especially important for patients on multiple medications (i.e. polypharmacy patients) or medications prescribed by multiple medical providers. Some employees may not want to explore personalized medication selection based on their genetic profile. However, medication treatment can still be personalized to some extent by utilizing CMM.

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CMM is utilized to assess current health, family history and PGx test results (if available) to ensure your employees are on the right medication, at the right dose and avoid drug waste and side effects. 

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According to the GTMRx Institute (Get The Medications Right Institute), employees (patients) are struggling to take the medications they are prescribed. This is contributing to non-optimized medication therapy as well as morbidity and mortality. 

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Furthermore, only 13% of primary care physicians consult with a pharmacist before prescribing new prescriptions.

(Preventing Medication Errors: A $21 Billion Opportunity. Network for Excellence in Health Innovation, 2011. http://www.nehi.net/bendthecurve/sup/documents/Medication_Errors_%20Brief.pdf. Accessed 4 Jan. 2018.) 

 

Understand, the retail pharmacist behind the counter does not have the availability that a consulting pharmacist at Bespoke Health has. The same is true of physicians talking to patients about new medications during office visits-one study estimates only about 49 seconds of a 15.9 minute average office visit is spent talking about new medication!

(Tarn, D. M., Paterniti, D. A., Kravitz, R. L., Heritage, J., Liu, H., Kim, S., & Wenger, N. S. (2008). How much time does it take to prescribe a new medication? Patient Education and Counseling, 72(2), 311-319. Accessed 14 December 2021. https://www.sciencedirect.com/science/article/pii/S073839910800116X?via%3Dihub )

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For more information on CMM visit this website for the GTMRx Institute: 

 

 

    https://gtmr.org/what-we-believe/ 

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By partnering with Bespoke Health, a pharmacogenomics-certified pharmacist can help to implement a personalized medication management approach for your employees.

 

PGx in coordination with CMM has been shown to:

• Reduce healthcare costs (by reducing Hospital/ER visits, admissions and PCP office visits)

• Decrease the chance that you will experience side effects 

• Decrease time spent on ineffective treatments due to one-size-fits-all drug selection

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Think of PGx as a proactive patient safety strategy. It's one more tool available to aid healthcare providers in precise, predictable prescribing.

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A genetic sample of DNA (from a cheek swab) will be analyzed by a laboratory. From that sample, gene variants are identified and translated to a genetic phenotype, which helps a pharmacogenomics-certified pharmacist at Bespoke Health decipher how your employee will metabolize medications differently than other people without that particular genetic variant.

 

If there is an actionable finding, the pharmacist consults with the employee's prescriber to suggest changing their current drug or dose, or proactively suggesting a drug and dose to start treating a new condition. If your employee does not have a health condition that needs to be treated currently, PGx information can still be analyzed and retained for future use- gene variants (from germline genetic mutations) are inherited and do not change over time. 

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PGx test results give healthcare providers the most innovative and powerful tools available to assist in selecting the most effective treatment, with the least likelihood of toxic side effects. 

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The body of evidence for PGx guidelines is growing every day.

Bespoke Health utilizes guidelines from CPIC (Clinical Pharmacogenetics Implementation Consortium) and PharmGKB, trusted experts in the field of pharmacogenomics. 

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If you wish to look at specific clinical data on the use of PGx for a particular therapy, Bespoke Health is happy to provide primary literature from which the CPIC guidelines are derived.