How pharmacists & PGx shorten medication prescribing ‘odyssey’ and improve patients’ health

The road is long — and rightly so — for a new, potentially transformative medical idea to travel from initial theory through research and finally to broad, evidence-based acceptance and best practice.

That’s the case with genomics in general, and perhaps preemptive pharmacogenomics (PGx) in particular. Practitioners’ positions on its effectiveness to guide clinical decision-making are still all over the map…though most oncologists, for example, agree on the value of its therapeutic guidance as they customize cancer-treatment protocols for each patient.

What providers mainly can agree on is that there’s some good science behind the genomics’ positive impact on at least some of the molecules. But there the agreement stops. Questions become how much broad value is there? What does testing cost my patient? And how do I realistically interpret and integrate PGx data into my busy medical practice, making it truly useful, actionable information?

 ‘Pharmacogenomics is an important part of precision medicine.’ — FDA

Good questions, and we don’t blame still-wary providers. A simple PGx lab test generates a lot of data — more than a busy clinician has the time or specialized training to interpret and leverage. Just this May, Health Affairs reported that in a survey of nearly 500 primary care providers in New York City about genetic testing, most held positive views about its value, but “were not confident about interpreting test results.”

We’ve been involved with PGx for a number of years, and are extremely excited by its continued progress. We’ve seen how it can help shorten the “therapeutic odyssey” you and your patients face — a prescribing journey of trial and error until you hit upon a drug combination that’s right for that individual’s unique makeup. And considering our nation’s aging adult population, a majority of whom have multiple chronic conditions, PGx has incredible potential to help interpret the many variables that stand in your way of delivering cost-efficient, effective, value-driven care.

The FDA agrees in the value of PGx. As it states on its website, “Pharmacogenomics is an important part of precision medicine. Healthcare providers can use pharmacogenomic information to help decide the most appropriate treatment for each individual. In addition, pharmacogenomics now plans an important role in the drug-development process, opening new opportunities in drug

 discovery.” The FDA’s Office of Clinical Pharmacology and specifically its Genomics and Targeted Therapy Group apply PGx and other biomarkers in all phases of drug development and clinical practice.

So…how do I use PGx?

While the body of knowledge reported is growing (and positive), we’re still back to the challenge most providers face, and what remains in your way of adopting one-on-one medication consulting, especially when it’s driven by preemptive PGx. Here’s where a combination of analytic tools and a specially trained pharmacist hold the key to unlocking the data’s value.

Pharmacists have a broad and deep knowledge of medications and potential adverse reactions. Whether it’s the possible contraindications of prescriptions from multiple providers, OTC meds (potenzmittel), supplements, food or other factors, clinical pharmacists are the people who can bring together all of this information from their position at the nexus of medication guidance. Consulting pharmacists — specially trained to interpret PGx data and freed from the retail world of pill dispensing — can ferret out the facts by talking one-on-one with your patient. Then they can provide you with invaluable information and insights that empower you to make the most-informed decisions. You’ll be better armed to positively affect your patient’s health and prove to value-based plans that you’re delivering high-value, high-impact care that achieves Triple Aim goals: improve health outcomes, curb costs and enhance the patient experience.

Pharmacogenomics: Important part of delivering value

Today, Medicare and many other plans cover annual or even monthly medication review by a clinical pharmacist, but too few people take advantage of it. The need for PGx education and medication counseling by consulting pharmacists becomes increasingly obvious if your practice, your patients and the country as a whole are to achieve the coveted Triple Aim goals.

In upcoming blogs, we’ll drill down into both the intertwined clinical and financial value of preemptive pharmacogenomics. The satisfaction of your patients — who will be spared the therapeutic odyssey, unnecessary adverse effects and costs and achieve better health more quickly — is a given.

You may also want to check out the following:

Should You Incorporate a Clinical Pharmacist into Your Practice?
CPC+ and the Clinical Pharmacist

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Bob Kropp , MD, MBA, CPHI
Bob Kropp, MD, MBA, CPHI, is a double-board-certified physician and Johns Hopkins-trained informaticist with more than 12 years of clinical practice and over 20 years of managed care experience who consults with RxLive. Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has more than a decade of experience in retail pharmacy settings. She became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.