Will Consultant Pharmacists Become Pharmacogenomics' Biggest Ally?

Although the goals of pharmacogenomics testing are lofty, they have the potential to change pharmacists’ practice. Reductions in trial-and-error medication costs and the number of patients on ineffective therapy could also save the US health system countless dollars.

So, why haven’t more practitioners and pharmacists embraced pharmacogenomic testing? The reason is multifaceted:

• We need to better identify patients who can benefit from it the most, specifically those with clinical concerns like dementia and pain.
• Practitioners are concerned the availability of testing data would render them more liable when injury occurs from an adverse drug reaction.
• There’s confusion about billing, ease of program implementation, and training to guide pharmacists and physicians through the process of interpreting test results.

However, I believe each of these issues can be solved by a single source: a consultant pharmacist intervention.

A consultant pharmacist can identify at-risk patients, work with their physicians to manage test results, and offer ongoing medication therapy management services afterwards. The consultant pharmacist can also decipher pharmacogenomics test results to determine whether patients have the proper enzymes to metabolize their medications.

One of the biggest barriers to implementing preemptive pharmacogenomic testing is reimbursement. Fortunately, there’s a company called PGx Medical specializing in serving the long-term care (LTC) market.

PGx Medical has been working with pharmacists since 2010 to provide these services under a Medicare-reimbursement model in the field of aging services. The company aligns current and future medications with each patient’s unique genetic profile, and then seamlessly integrates the pharmacogenomic information into the consultant pharmacist’s workflow.

Patients receiving care from LTC consultant pharmacists and physicians focused on LTC are identified and assessed through a Metabolic Validation Program. This means dollars aren’t wasted on unnecessary tests for low-risk patients—another common barrier to pharmacogenomic testing.

Part of the process is identifying a patient during normal medication reconciliation, and then recommending a physician order or standing test protocol. Once the physician orders pharmacogenomic testing, the patient is swabbed and the results are returned to the consultant pharmacist, who would then work with PGx Medical to view results and receive training on interpreting them. Finally, an implementation plan is put in place, and recommended changes are communicated to the ordering physician. Meanwhile, the consultant pharmacist has the patient’s results to refer to in the future as new medications are added.

It makes sense to entrust the health care professionals with the most training in the absorption, distribution, metabolism, and excretion of medications with patients’ pharmacogenomic data. As more pharmacists begin offering pharmacogenomic testing as part of their normal operations, personalized medicine will become more prevalent, and the need for companies like PGx Medical will become paramount.