Healthcare provision is evolving. As the industry transitions to a value-based care system, care providers are abandoning the one-size-fits-all treatment methodology in favor of a more personalized and tailored approach.
Pharmacogenetics—the study of how an individual’s genetic makeup impacts their response to drugs—has become an essential component of this personalized care strategy. By using pharmacogenetic testing, healthcare providers can identify genetic variations that may affect a patient’s response to medication, allowing for a more tailored and effective treatment plan.
But what are the benefits of pharmacogenetics?
First, What Are Pharmacogenetics?
This newly emerging medicinal field combines pharmacology (the science of drugs and medicine) and genomics (the study of genes and their function) to develop safe and effective medications.
Pharmacogenetics is based on the understanding that while a drug may have a general effect on most patients, it will not necessarily have the same effect on everyone. This is because individual genetics can have a significant impact on how a patient responds to a certain medication. Pharmacogenetic testing can help identify:
- Which patients are more likely to respond well to a medication, and how much of a response they are likely to experience
- Which patients may not respond to a medication at all
- Which patients may be at a higher risk of experiencing an adverse drug reaction due to genetic factors
By analyzing a patient’s genetic makeup, pharmacogenetics can provide actionable insights that make it possible to tailor medication regimens to each individual’s needs. As the CDC notes, your DNA can impact drug response in a number of ways:
- Drug receptors – Drugs need to attach to receptors to work properly, but your genetics impact the type of receptors you have and how many you have, which would change the required dosage.
- Drug uptake – DNA can impact both drug uptake and removal, which can lead to disparities in how medications work and their efficacy.
- Drug breakdown – Genetics dictate how quickly your body breaks down a drug. If the breakdown is fast, you may need a higher dosage. Conversely, if it’s slow, you’ll need a smaller dosage.
- Mutations – Some diseases are caused by genetic mutations. But drugs can be developed to specifically address these variations.
Benefits of Pharmacogenetics
Historically, traditional medicine relied on a universal medication management strategy, where patients received the same medications and dosages without accounting for their individual characteristics or preexisting medications.
But now, healthcare providers can analyze a patient’s unique genetic makeup to design a bespoke medication regime tailored to an individual’s needs, genetic markers, and health conditions.
Ultimately, this personalization strategy ensures that patients receive the medications and dosages that are most likely to have a positive impact. And this approach can create a host of secondary benefits, including:
1. Increased effectiveness – Pharmacogenetics makes it possible for care providers to determine which medications are likely to be the most effective for a particular patient, which can improve treatment outcomes and reduce their prescription spend.
2. Better prescription management – 29% of Americans are on a polypharmacy schedule (taking five or more medications simultaneously). Applying a pharmacogenetics approach to medical management can help reduce the use of ineffective drugs that overlap with one another, which helps both patients and providers save money.
3. Reduced risk of adverse reactions – Instead of prescribing a drug and waiting to see how a patient might react, care providers can proactively identify potential genetic markets that might cause a patient to have an adverse reaction to a specific drug, which can have positive downstream impacts for everyone.
4. Improved drug discovery and development – Pharmacogenetics helps researchers identify genetic targets for new medications and better understand how medications interact with various genetic profiles, which can accelerate discovery and development while improving outcomes.
A Pharmacogenetic Case Study
Alice, a 67-year-old woman was given a prescription for a highly concentrated insulin known as Toujeo.
BeneCard PBF’s pharmacists reviewed the medication and dosage to verify that Alice had the right drug and dosage. The medical expert quickly found that the submitted claim was for an unusually high quantity of insulin.
Upon consulting with Alice’s prescriber, it was revealed that they had prescribed 300% more than Alice’s optimal maximum dose. Instead of the recommended 450 units per day, Alice only needed 150 units per day.
If Alice had simply followed the recommended schedule, she could have developed life-threatening hypoglycemia. This pharmacogenetic intervention not only potentially saved Alice’s life but also saved the plan $10,000 and the member approximately $8,000.
Working with BeneCard PBF
Pharmacogenetics is revolutionizing the way we view medication management. By taking a more personalized approach, patients can pay less while receiving more effective treatment.
At BeneCard PBF, we’re a pharmacy benefit manager (PBM) that leverages pharmacogenetics to put patients first to improve healthcare outcomes, increase transparency, and lower costs. Plus, we’re the only PBM to accommodate pharmacogenetics at the point of sale.
We work directly with prescribers, pharmacists, and providers to ensure that each of our members has the right drug and dosage, at a reasonable price.
Want to discover more about our modern approach to prescription benefits management? Contact us today.
Sources:
CDC. Pharmacogenomics: What does it mean for your health? https://www.cdc.gov/genomics/disease/pharma.htm
NIH. Pharmacogenomics: The Right Drug to the Right Person. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299179/