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Genetic Test Found to Save Drug Expense, Boost Adherence

Spilled pills


13 August 2015. A genetic test to guide the choice of drugs prescribed to patients with psychiatric disorders was found to reduce the cost of medications to those patients and improve adherence to the drugs prescribed, compared to patients who were not given the test. Results of the study evaluating the GeneSight test, made by Assurex Health in Mason, Ohio, appear in a recent issue of the journal Current Medical Research and Opinion.

The GeneSight test analyzes a patient’s DNA from a mouth swab sample, to better understand how drugs would affect that individual. The analysis looks at genes involved in the body’s reactions to medications, including their absorption, distribution, metabolism. and elimination. The test also covers genes affected by the drugs’ therapeutic mechanisms.

Assurex says its technology assesses the actions of potential drugs on patients, which for neurological and psychiatric medications is important, since drugs for these disorders often work through multiple genetic pathways. The company offers genetic assessments specialized for psychotropic conditions such as depression or PTSD, chronic pain, ADHD, and folate deficiency associated with individuals having depression. Assurex licensed its technology from Mayo Clinic and Cincinnati Children’s Hospital Medical Center.

The study, conducted by Assurex with the pharmacy benefit management company Express Scripts, reviewed insurance claims records from an Express Scripts database over a one-year period. A group of more than 2,100 individuals given the GeneSight test for psychotropic conditions was matched against a group of nearly 11,000 people newly prescribed a psychiatric drug or who switched to a new drug. People in the both groups were participants in the pharmacy benefit plan for at least six months. The research team looked at the number and costs of drugs being prescribed, as well as adherence by patients to their medications, defined as proportion of days covered during a specified period of time.

The results show individuals first receiving the GeneSight test had lower overall costs for their drugs, stayed with prescriptions more than people not receiving the test, and in some cases reduced the number of medications taken. Drug costs for patients tested with GeneSight were on average $1,036 lower than individuals in the comparison group.

In addition, one of five people receiving the GeneSight test were prescribed fewer medications, which helps address the problem of polypharmacy — too many drugs being taken from too many prescriptions — often an issue for the elderly. The findings also show individuals receiving the GeneSight test stayed with their prescription regimens by a 17 percent margin more than people in the comparison group.

The journal article notes some limitations to the study. The analysis covers only a one-year period, so there are no data on longer-term implications. Likewise, the comparison group was chosen only on the basis of demographic characteristics and psychiatric conditions, thus there may be other confounding factors at work.

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