For Collaborating Pharmacists and Pharmacies

We believe that pharmacists are the most qualified healthcare professionals to interpret pharmacogenetic tests.

Benefits of Using Our Pharmacogenetic Test at your Pharmacy:

  • Increased patient satisfaction in the level of service provided at your pharmacy
  • Adequate pharmacy reimbursement for the cognitive service
  • Additional training to help pharmacists in the day-to-day care of their patients
  • Summary reports with concise interpretation to aid in the care of your patients (along with the level of evidence used to support that recommendation)
  • Opportunity to consult our in-house pharmacists to help with test interpretation

 

Training:

Training by a PharmD with a research background in pharmacogenetics comes with the package offering of testing at your pharmacy, at no extra charge. We provide a continuous learning opportunity. This is especially important considering the speed at which this field is advancing, and the current move towards “pharmacogen-o-mics” – the practice of looking at multiple genes to determine drug response.

Our in-house pharmacists are also available to help with test interpretation and answer any questions that you may have regarding the summary reports generated for your patients.

 

Genes Tested:

At Personalized prescribing, we test both the pharmacokinetic AND pharmacodynamics genes involved in response.

Sample- NOT a comprehensive list:

Pharmacokinetic Genes

Pharmacodynamics Genes*

–       CYP3A4/5

–       CYP2D6

–       CYP2C9

–       CYP2C19

–       CYP1A2

–       ABCB1

 

Serotonin response pathway:

  • HT2R2A, GNB3, 5HTTLPR, TPH1, BDNF, FKBP5

Dopamine/Norepinephrine pathway:

  • DRD2, DRD3, ADRA2A, COMT

Metabolic risk on antipsychotics:

  • HTR2C, MC4R, FAAH, CNR1, etc.

 

* These genes can be direct targets of the drug, whereby genetic variations can affect drug binding OR they may be indirectly involved in the drug’s response pathways.

Practical Application of the Test:

Our pharmacogenetic test can be used to predict:

  • Concentration of the drug attained in the body
  • Likelihood of response to SSRIs versus SNRIs
  • Risk of cognitive dysfunction (i.e. memory problems) on certain SSRIs
  • Likelihood of response as well as risk of psychosis on stimulants (i.e. methylphenidate)
  • Likelihood of response as well as risk of tardive dyskinesia/weight gain on antipsychotics
  • Likelihood of experiencing muscle pain on statins, as well as rare ADRs (i.e. carbamazepine-induced hypersensitivity & valproic acid hepatotoxocity), to name a few.

Please visit our drug list section for a comprehensive list of drugs tested.

Standard of Practice

The pharmacogenetic recommendation made by a pharmacist should always be accompanied by the level of evidence made to support care.

We find that it is not enough to just look at how the patients break down medications, but it is equally important to try to understand what is happening at the level of the receptors that are involved in efficacy/side-effects. Though we realize that the level of evidence concerning pharmacodynamics genes is often not as strong as with the pharmacokinetic genes, we hope to provide some prescribing guidance, especially in lieu of the predominant alternatives in certain fields (i.e. trial and error approach in the fields of pain and chronic medicine).

 

We only use genes that have been validated at the highest level by international consortia:

  • Clinical Pharmacogenetics Implementation Consortium (CPIC)
  • Dutch Pharmacogenetics Working Group (DPWG)

 

These consortia comprise groups of researchers, physicians, pharmacists, and industry leaders well-versed in pharmacogenetics.  These consortia also qualify the level of evidence, which we use to support our recommendations in the summary report given for each patient.

Applied practice generally differs from the randomized-controlled trial setting as it involves individual patients, wherein multiple genes interact to provide response.  When using pharmacodynamics in the practice-based setting, it is important that both the physician & patient are made aware that there can be other untested clinical factors that can also affect response.

 

Pharmacists are generally familiar with the many variables that can affect drug response:

Figure from Pharmaceuticals 2010, 3(5), 1637-1651; doi:10.3390/ph3051637

 

Patients must be advised to follow-up with their physician, as he/she will corroborate pharmacogenetic findings along with the patient’s clinical history and response to treatment. It is also important to clarify that this test is not used for diagnostic purposes. It is only used to identify potential drug therapy problems.

Pharmacy Compensation

We believe that pharmacists should be adequately reimbursed for their cognitive service. Pharmacists can discuss the results with their patients, using our summary reports as a guide.

In addition to adequate compensation per test, there are also opportunities for returns based on volume.

 

Please contact Mark Faiz (mfaiz@personalizedprescribing.com)  for a quote, if you would like to use our pharmacogenetic test at your pharmacy.