Incidence of Exposure of Patients in the United States to Multiple Drugs for Which Pharmacogenomic Guidelines Are Available

Pre-emptive pharmacogenomic (PGx) testing of a panel of genes may be easier to implement and more cost-effective than reactive pharmacogenomic testing if a sufficient number of medications are covered by a single test and future medication exposure can be anticipated. We analysed the incidence of ex...

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Published in:PloS one Vol. 11; no. 10; p. e0164972
Main Authors: Samwald, Matthias, Xu, Hong, Blagec, Kathrin, Empey, Philip E., Malone, Daniel C., Ahmed, Seid Mussa, Ryan, Patrick, Hofer, Sebastian, Boyce, Richard D.
Format: Journal Article
Language:English
Published: United States Public Library of Science 20.10.2016
Public Library of Science (PLoS)
Subjects:
Adolescent
Adult
Aged
Artificial intelligence
Biology and Life Sciences
Child
Child, Preschool
Complications and side effects
Consortia
Cost analysis
Cost-Benefit Analysis
Databases, Factual
Drug dosages
Drug Prescriptions - economics
Drug Prescriptions - statistics & numerical data
Drug therapy
Drug-Related Side Effects and Adverse Reactions - economics
Drugs
Ethnicity
Exposure
Female
Genotype & phenotype
Government programs
Guidelines
Health care
Humans
Incidence
Infant
Infant, Newborn
Informatics
Internet
Male
Medicaid
Medical screening
Medical statistics
Medicine and Health Sciences
Middle Aged
Patients
Pharmacogenomic Testing
Pharmacogenomics
Pharmacology
Pharmacy
Practice guidelines (Medicine)
Practice Guidelines as Topic
Prescription drugs
R&D
Research & development
Risk
Social Sciences
Studies
United States
Young Adult
New York
Austria
Pittsburgh Pennsylvania
United States > US
Pennsylvania
ISSN:1932-6203, 1932-6203
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Abstract Pre-emptive pharmacogenomic (PGx) testing of a panel of genes may be easier to implement and more cost-effective than reactive pharmacogenomic testing if a sufficient number of medications are covered by a single test and future medication exposure can be anticipated. We analysed the incidence of exposure of individual patients in the United States to multiple drugs for which pharmacogenomic guidelines are available (PGx drugs) within a selected four-year period (2009-2012) in order to identify and quantify the incidence of pharmacotherapy in a nation-wide patient population that could be impacted by pre-emptive PGx testing based on currently available clinical guidelines. In total, 73 024 095 patient records from private insurance, Medicare Supplemental and Medicaid were included. Patients enrolled in Medicare Supplemental age > = 65 or Medicaid age 40-64 had the highest incidence of PGx drug use, with approximately half of the patients receiving at least one PGx drug during the 4 year period and one fourth to one third of patients receiving two or more PGx drugs. These data suggest that exposure to multiple PGx drugs is common and that it may be beneficial to implement wide-scale pre-emptive genomic testing. Future work should therefore concentrate on investigating the cost-effectiveness of multiplexed pre-emptive testing strategies.
AbstractList Pre-emptive pharmacogenomic (PGx) testing of a panel of genes may be easier to implement and more cost-effective than reactive pharmacogenomic testing if a sufficient number of medications are covered by a single test and future medication exposure can be anticipated. We analysed the incidence of exposure of individual patients in the United States to multiple drugs for which pharmacogenomic guidelines are available (PGx drugs) within a selected four-year period (2009-2012) in order to identify and quantify the incidence of pharmacotherapy in a nation-wide patient population that could be impacted by pre-emptive PGx testing based on currently available clinical guidelines. In total, 73 024 095 patient records from private insurance, Medicare Supplemental and Medicaid were included. Patients enrolled in Medicare Supplemental age > = 65 or Medicaid age 40-64 had the highest incidence of PGx drug use, with approximately half of the patients receiving at least one PGx drug during the 4 year period and one fourth to one third of patients receiving two or more PGx drugs. These data suggest that exposure to multiple PGx drugs is common and that it may be beneficial to implement wide-scale pre-emptive genomic testing. Future work should therefore concentrate on investigating the cost-effectiveness of multiplexed pre-emptive testing strategies.
Audience Academic
Author Blagec, Kathrin
Ryan, Patrick
Boyce, Richard D.
Samwald, Matthias
Malone, Daniel C.
Hofer, Sebastian
Ahmed, Seid Mussa
Xu, Hong
Empey, Philip E.
AuthorAffiliation 5 Janssen Research and Development, Titusville, New Jersey, United States of America
4 Department of Pharmacy, College of public health and medical sciences, Jimma University, Jimma, Ethiopia
2 Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
7 Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
Case Western Reserve University, UNITED STATES
1 Section for Artificial Intelligence and Decision Support; Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
6 Observational Health Data Sciences and Informatics, New York, New York, United States of America
3 College of Pharmacy, University of Arizona, Tucson, Arizona, United States of America
AuthorAffiliation_xml – name: 1 Section for Artificial Intelligence and Decision Support; Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
– name: 2 Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
– name: 3 College of Pharmacy, University of Arizona, Tucson, Arizona, United States of America
– name: Case Western Reserve University, UNITED STATES
– name: 6 Observational Health Data Sciences and Informatics, New York, New York, United States of America
– name: 4 Department of Pharmacy, College of public health and medical sciences, Jimma University, Jimma, Ethiopia
– name: 7 Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
– name: 5 Janssen Research and Development, Titusville, New Jersey, United States of America
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  orcidid: 0000-0002-4855-2571
  surname: Samwald
  fullname: Samwald, Matthias
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  surname: Xu
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  givenname: Richard D.
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/27764192$$D View this record in MEDLINE/PubMed
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This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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Competing Interests: PR is an employee of Janssen Research and Development. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Conceptualization: MS RDB. Formal analysis: MS HX KB PEE DCM RDB. Funding acquisition: MS RDB. Methodology: MS HX KB PEE DCM PR SH RDB. Project administration: MS RDB. Software: MS HX SH RDB. Writing – original draft: MS KB RDB. Writing – review & editing: MS HX KB PEE DCM SMA PR SH RDB.
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Snippet Pre-emptive pharmacogenomic (PGx) testing of a panel of genes may be easier to implement and more cost-effective than reactive pharmacogenomic testing if a...
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Pharmacogenomic Testing
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Pharmacology
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Practice Guidelines as Topic
Prescription drugs
R&D
Research & development
Risk
Social Sciences
Studies
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Title Incidence of Exposure of Patients in the United States to Multiple Drugs for Which Pharmacogenomic Guidelines Are Available
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