Is Pharmacy the Missing Link in Pharmacogenetic Testing?

Pharmacogenetics is a unique and lucrative opportunity for pharmacists to expand their role in patient care, according to a session during the 2021 Pharmacy Profit Summit, which streamed virtually on May 11.¹

Brad Tice, PharmD, MBA, FAPhA, immediate past president of American Pharmacists Association (APHA) and founder of RxGenomix, discussed important insights in the pharmacogenomic (PGx) space with host Lisa Faast, PharmD, CEO of DiversifyRx. 

Throughout his career, Tice has helped align community pharmacy with prioritized patient care. “The role of pharmacy is to get patients on the right medications, use those medications the right way, and achieve the desired resulted with those medications…and to get pharmacists paid to do those things,” he said.

 Implementation of PGx has the potential to prevent serious complications that can occur. “Pharmacogenetics belongs in the space of the pharmacist. The pharmacist is the drug-knowledge expert, and no matter what that drug knowledge interacts with – whether it’s your genes, with other drugs, or nutrition – I think the role lands with pharmacists,” said Faast. 

One of the challenges to advancing pharmacogenetics in the last several years has been the position the FDA has taken on pharmacogenomics testing, Tice explained. However, last February, the agency provided clarity on this matter. “The FDA treated labs doing pharmacogenomic testing similar to how the FDA has treated pharmacists doing compounding. What the FDA really has not liked is the labs sending a report to a patient…without the clinician’s involvement,” Tice said. This could lead to a patient altering their medication regimen without being effectively consulted on some of the important clinical factors, according to Tice. Pharmacists are well-positioned to fill that gap between the lab and the patient.

A large portion of patients who would benefit from pharmacogenetic testing would be those taking medications for anxiety, depression, cardiovascular diseases, and pain, Tice said.

As for reimbursement, Tice said that Medicare recently expanded their reimbursement terms, and there are now more private payer options as well. More than that, though, Tice said that pharmacogenetics is a great opportunity from a cash pay perspective.

“One of the things that I’ve loved about pharmacogenomics…is it meets the criteria of new and different. The patient quickly understands that nobody else in their health care is talking to them about how their genetic profile impacts their response to their medications,” Tice highlighted. Patients will also see the value in having their pharmacist, in particular, doing this test for them.Innovations in the pipeline include a subscription service for storing a patient’s pharmacogenomic profile within the pharmacy workflow software, in which the pharmacist can “check against the genetic profile, just like you check for drug interactions,” Tice said. 

But do pharmacists need to have specific geneticist-related skills to be able to offer pharmacogenomic testing? Tice said no, but it’s probably smart to take advantage of the resources for pharmacists to get more acquainted with the pharmacogenetic space. RxGenomix has developed a free 1-hour introductory course, as well as an 8-hour course. Tice explained that becoming comfortable with the ins-and-outs of pharmacogenetics just takes some practice and quickly becomes routine. “It will probably be little intimidating at first…but you can be up and running really in less than a week,” he said.

Reference

• Tice B, Faast L. Non-PBM Revenue Opportunities. Presented at: The 2021 Pharmacy Profit Summit; May 10-15, 2021; virtual. Accessed May 12, 2021. https://www.pharmacyprofitsummit.com/pharmacy-profit-summit-day2-live48235716.