Insurance

One-size-does-not-fit all

It is evident that patients with the same diagnose given the same medication may not respond the same way on medication.

https://www.pharmgkb.org/annotatedDrugs

The “trial and error” selection of medicine method has been used among Doctors for ages and they have had no other options until now.

The percentage of patients who receive a non-effective drug prescription with “trial-and-error” selection of medicine method is shown below – e.g., 38% of patients given an anti-depressant SSRI and 50% of arthritis patients did not get an effective treatment from the first prescription.

Depression 38%
Asthma 40%
Cardiac Arrythmias 40%
Diabetes 43%
Migraine 48%
Arthritis 50%
Osteoporosis 52%
Alzheimer’s 70%
Cancer 75%

Persentage of Patients for Whom a Drug is ineffective, on Average

Source: Brian M Spear et al. Clinical Trends in Molecular Medicine; Volume 7; Issue 5; 1. May 2001: page 201-204

The Mayo Clinic in US showed that when using a pharmacogenomic guided treatment of depression, symptoms could be reduced four times better than compared to “trial & error” selection of drugs (31.2% reduction versus 7.2% reduction) .

A good example can be found in a study from the Netherlands, 2016, with preventive testing of DPYD with subsequent guided pharmacogenomic dosing was performed5 . The doctors were able to reduce fluoropyrimidine-induced toxicity in anti-cancer treatment compared to a historical control group from 73% to 28% and at the same time reduce the number of deaths induced by drugs from 10% to 0%.

Subsequently, the European Medicine Agency (EMA) recommends a genetic test prior to the use of Fluoropyrimidines.

https://www.ema.europa.eu/en/medicines/human/referrals/fluorouracil-fluorouracil-related-substances-capecitabine-tegafur-flucytosine-containing-medicinal

Only once investment

Advancement in technology have made it possible to identify genetic variations patient by patient and thereby a potential exists for payors to adopt initiatives to contain cost and increase the value of health care benefits. Personal Medicine Profile analysis must be carried out only once – it is a once only investment.

The test does not have to be repeated as the case we know from e.g., blood samples or X-rays for medical conditions. Without extra costs free updates of new medication with pharmacogenomic guidelines are continuously updated for each report. This means that healthcare personnel will be able use the latest recommendations whenever the patient is re-admitted to the sector.

The integration of pharmacogenomics into clinical practice provides physicians and pharmacists a powerful tool to personalize medical treatment, better manage costs and utilize more value from effective medication management.

Using the right medication early on may shorten the course of illness and make it better to be a patient in the healthcare sector 6.

Can wrong medication cause hospitalisation

In some countries e.g., Denmark, hospitalization due to medication errors is not registered. However, in England and Belgium, it is found that 6.5% – 10% of all hospitalizations are due to medication errors. It is estimated to be at the level of 10% in the Scandinavian countries.

Patients with adverse drug reactions have a longer length of stay at hospital than those without (4 vs 3 days depending on guidelines for hospitalization6)

Recent investigations into adverse drug reaction hospitalization concluded that 30% of adverse drug reactions at admission were caused by at least one drug with Pharmacogenomic guidelines, suggesting many ADRs could have been predicted by Pharmacogenomic testing6

Cost-benefit

The costs of analysing one gene in a hospital setting compared to multiple genes in a Personal Medicine Profile setting is the same4.

Very often patients have more than one medical condition. The benefit of using a multiple gene platform as Personal Medicine Profile is to get a broader insight of a wide range of the most popular medications within heart, pain, gastroenterology, rheumatism, psychiatry and cancer treatment in just one test.

The field of pharmacogenomics is gradually shifting from reactive testing of single genes towards the proactive testing of multiple genes to be able to help patients with more than one condition and decrease the burden of unnecessary costs for healthcare systems.

Personal Medicine Profile is a decision support tool to help selecting the optimal treatment to improve the treatment success early on in general pracitice and contribute to a shorter length of disability and lenght of stay at the hospital.

Personal Medicine Profile is one of the broad pharmacogenomic test covering a multiple set of genes and more than 200 ingredients.

The road to personal medicine

Over the years scientific and technological advances have transformed medical practice to offer novel approaches to improve patient care.

More recently the convergence of technologies such as genomics and informatics is presenting significant opportunities to drive improvements through more personalised treatment and care for patients.

In recognition of these opportunities, many countries in EU has set out their vision for personalised medicine and how they intend to build on the work undertaken as part of genomic projects in each country.

There is a growing emphasis on the need for improvement in the effectiveness which fosters innovation and delivers it to paitents, in order to improve outcomes, to support the national economic interest and ultimately to ensure the long term sustainability of the social security in each country.

We need to mention, that Personal Medicine Profile is not yet a part of any national genomic project, but are set-up to deliver.

Genetelligence are under no influence from the pharmaceutical industry.
We do not recommend or highlight any brand from a particular company – we focus on the active pharmaceutical ingredient and leave the decision about brand to the payor, the clinicians and the customers.

3) Reisberg et al: translating genotype data of 44.000 biobank participant´s into clinical pharmacogenetic recommendation. Genet Med 2019: 21(6): 1345-54
4) The price compared are the list price from a one-gene-test (DPYD) in a hospital setting in DK to the price of a PMP report of 20 genes.
5) Deenen MU et al. Upfront genotyping of DPYD*2A to individualize fluoropyrimidine therapy: a safety and cost analysis: J. Clin. Oncol. 2016; 34(3) 227-34
6) Chan SL et al. Br. J Clin Pharmacol (2016) 82: 1635-1646

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