The Future of Medicine: DNA Testing to Optimize Medication Management


By Dr. Jessica Lea
Tria Health

Pharmacogenomics (PGx) is a field of medicine that studies the impact of an individual’s genetic makeup and their response to medications.  The goal is to personalize treatment by identifying genetic variations that impact how a person’s body metabolizes a particular medication. This information can help a provider select the most effective and safe drug for an individual, determine the optimal dose reducing the risk of side effects and optimizing medication use.

Everyone’s genetic makeup is unique, and this variation influences how a body processes medication. By studying the interactions between a person’s genes and drugs, researchers can develop a better understanding of how drugs work in the body and identify ways to optimize treatment to ensure the right person gets the right medication.

PGx testing is especially effective with conditions such as mental health, which is complex and multi-faceted. It includes a wide range of disorders including depression, anxiety, bipolar disorder and more. It is a condition where finding the right medication and dose is challenging. PGx can play a significant role in reducing trial and error prescribing that can be frustrating for both the patient and the prescriber.

To illustrate the benefit of PGx, let’s consider a patient at Tria Health with a history of poorly controlled mental health. The patient had been taking a medication commonly prescribed to treat anxiety and depression for four months.  Despite a recent dose increase, the patient had not seen an improvement in symptoms.  After conducting pharmacogenomics testing, we discovered the patient had a genetic variance that resulted in rapid metabolism of that particular medication. This prevented the drug from achieving a therapeutic concentration, which explained why the patient had not seen any improvement. We were able to pinpoint a treatment option that avoided the patient’s drug-gene interactions.  The patient is now taking the new medication and tolerating it well, with a significant improvement in their anxiety and depression symptoms.

What Does This Mean for Employers?

Pharmacogenomics has great potential to improve health outcomes and reduce the risk for adverse drug reactions, which is a major cause of emergency room visits and hospitalizations each year. This, in turn, reduces healthcare costs for an employer’s health plan.  However, there are still a few challenges that exist.  One, the test results are generally presented in long complicated report that is difficult to understand. A qualified health professional is essential to ensuring appropriate interpretation of the  results for patients.  Many times, additional education is required for providers who are not as familiar with pharmacogenomic test results. Second, these tests can be cost prohibitive, making it impractical to offer as a healthcare benefit to all employees and/or members.

However, employers can still control costs and reap the benefits of PGx testing by developing a plan design that provides testing to high-risk individuals who stand to benefit the most.  This targeted approach will ensure that resources are allocated in a manner that maximizes the value of PGx testing, reducing overall healthcare costs and ensuring happier, healthier employees.

Overall, PGx testing has the potential to revolutionize the way drugs are prescribed, making them safer and more effective for individual patients.

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