Saturday, May 9, 2015

Genetic testing helps determine prescriptions

Patients covered by Medicaid in Colorado are being given genetic testing to determine which medications they should receive.
The idea is catching on fast, and Medicare is paying for it.
The idea is that by checking for genetic variants doctors will be able, in some cases, to determine which drugs to prescribe and even dosage.
Dr. James Kennedy, at the University of Toronto, and other psychiatrists, say the program is promising.
 “The genetic testing for medication choice has a good core of validity, particularly with the liver enzyme genes, said Kennedy.
He cautions that the idea is in its early development stage, and is complicated. Kennedy is starting “a study that is a randomized controlled trial of pharmacogenetic testing versus treatment as usual on 1,200 mental health patients… It
compares the Assurex Health GeneSight Psychotropic test with a modified version of that test that contains 8 new markers from my lab, and both of these arms will be compared to Treatment As Usual.”

The company’s Web site says: “The GeneSight Psychotropic laboratory developed test analyzes how your genes affect the way your body may respond to FDA-approved medicines commonly prescribed to treat depression, anxiety, bipolar disease, schizophrenia or other behavioral health conditions.”  
Hollywood has already latched on to the idea. A recent episode of “The Blacklist” involves developing a WID, a weapon of individual destruction. It would create a virus that would kill only the person with a specific DNA.
Some companies are already offering such tests, with a “complete panel” of tests costing less than $1,000 for someone with no insurance, said Jodie Cadieux of Genelex.
Lists of drugs are available showing drugs that are affected by known genetic variants, she said.
On the Net, companies ask whether patients want to receive drugs that are tailored for the masses, or shown to work for them specifically.
Commercials on TVs scare the hell out of people by suggesting they try a new drug and then warning that they cause everything but St. Vitus Dance and Ebola.
Cadieux cites two reasons why such testing is important. Eighty percent of the nation has at least one genetic variation.
And many patients receive multiple prescriptions, which can create “a traffic jam in the liver,” where they are metabolized by five cytochromes.
President Obama has talked about the need for what is being called “precision medicine” both to improve care and bring down costs.
Given the reception theories like climate change have received by the anti-science community in the U.S., Genelex has reviewed 17,000 scientific publications on genetic testing to confirm the idea’s validity. It has a list of drugs affected by variants.
Opponents of science have already questioned Medicare’s payment of fees for DNA testing.

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