Raymond A. Lorenz, PharmD, BCPP & Niharika Koppulu
Pharmacogenomics-Enriched Comprehensive Medication Management: A Retrospective Cohort Study. Did you know over 99% of patients have genetic variations impacting their response to drugs (Chanfreau-Coffinier, et al. 2019)? To optimize medication effectiveness, healthcare providers are increasingly adopting Comprehensive Medication Management (CMM), a patient-centered approach delivered by pharmacists within a collaborative healthcare team. A recent study published in the Pharmacogenomics Journal explores the clinical and economic impacts of a pharmacogenomics (PGx)-enriched CMM approach to patient care (Fragala, et al. 2024).
PGx+Comprehensive medication management resulted in significant decrease in ER and inpatient visits. Clinical outcomes. The study compared 452 participants receiving PGx+CMM with 1,500 matched controls in a 1:4 ratio. Over a 26-month period, patients in the interventional group demonstrated a statistically significant decline in emergency room and inpatient visits (p=0.05 and p=0.002, respectively). Conversely, outpatient visits significantly increased (p<0.001) compared to matched controls (p<0.001) (Fragala, et al. 2024). The increase in outpatient visits likely reflects recommended follow-up appointments per PGx+CMM guidelines.
PGx+CMM-guided recommendations prioritize clinical superiority over cost minimization. Economic outcomes. The study revealed a significant reduction in inpatient costs (p=0.04) and a decline in emergency department expenses trending towards significance. On the other hand, pharmacy costs rose significantly (p<0.003). This may be the result of traditional prescribing practices in the control group, which is rooted in drug cost minimization and formulary coverage. Meanwhile, PGx+CMM-guided recommendations prioritize clinical efficacy and reduced adverse drug events, leading to potentially more expensive but clinically superior treatments (Fragala et al., 2024).
Future research should explore tradeoff between direct and indirect medical costs. The findings of this study suggest that incorporating PGx and CMM recommendations into treatment decisions can enhance clinical outcomes, despite potentially increasing pharmacy costs. By customizing treatment plans according to individual genetic profiles and medical histories, healthcare providers can minimize adverse events and maximize therapeutic benefits, thereby enhancing patient care. Future research should focus on exploring the tradeoff between direct medical costs (e.g. out-of-pocket expenses) and indirect medical costs (e.g. reduced quality of life).
Learn more about UGenome’s Personalized Medication Service, ProPEx, or contact UGenome. You can also find case studies for UGenome’s bioinformatics services Metabolite Identification, Bone Metastasis Risk Analysis in Breast Cancer, Survival Analysis with gene signatures in cancer
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