The Value of PGx
Pharmacogenomic (PGx) testing analyzes how a person’s genes affect their response to medications. This personalized approach is proving to be a cost-effective and cost-saving strategy for healthcare systems and payers. By preventing adverse drug reactions (ADRs) and optimizing treatment, PGx testing reduces morbidity, mortality, and overall healthcare costs. This is especially true in areas like depression, cardiovascular disease, and chronic pain management.
Cost-Saving & Cost-Effective PGx Strategies
PGx testing can be a dominant strategy, meaning it is both more effective and less expensive than traditional trial-and-error prescribing.
- Cost-Effective: More effective than standard care at an acceptable additional cost.
- Cost-Saving (Dominant Strategy): More effective than standard care at a lower cost.
The Problem: Adverse Drug Reactions & Ineffective Treatments
Adverse drug reactions (ADRs) are a major concern, particularly in geriatric patients who often take multiple medications (polypharmacy). Patients taking more than 10 medications have a 9-fold increased risk of ADR-related hospitalization. A key cause of these reactions is genetic variation in cytochrome P450 (CYP) enzymes, which are responsible for drug metabolism. PGx testing can predict these genetic variations, helping to prevent dangerous drug-gene interactions (DGIs) and drug-drug interactions (DDIs) before they occur.
Focus Areas with Proven Economic Benefitss
Chronic Pain Management: The total financial cost of chronic pain is substantial, reaching up to $635 billion annually. PGx testing has a huge cost-saving potential here. In one study, 83% of pain management patients had a medication change due to a DDI or DGI following PGx testing, and
PGx-guided opioid therapy significantly reduced pain and ADRs.
Depression: Most depression treatment occurs in primary care, which is also where PGx testing offers the most significant cost savings. Panel-based PGx testing for depression has been shown to be a cost-effective or cost-saving approach, providing a savings of up to $3,988 per member annually for insurance companies and patients.
Cardiovascular Disease (CVD): Given that CVD is the leading cause of death globally, PGx’s impact on this area is immense. For patients undergoing percutaneous coronary intervention (PCI), PGx testing for the CYP2C19 gene is considered medically necessary by Medicare. One study showed that using PGx to guide medication changes reduced antihypertensive efficacy by 58%, significantly lowering blood pressure.