IT IS NOW POSSIBLE TO DETERMINE, WITH A HIGH
LEVEL OF CONFIDENCE, THE APPROPRIATE DRUG, AT
THE CORRECT DOSE, WITH MINIMUM SIDE EFFECTS.
(action of drugs) and genomics (study of genes/genome) to tailor
medications and doses to a person’s genetic make-up.
It provides physicians with insights to personalize a prescrip-tion
treatment plan that was otherwise unattainable and based
on a “one-drug-fits-all” mentality. For example, take the cur-rent
method of prescribing in the field of mental health: It is not
derived from any scientific tools that help predict who will and
won’t benefit from a medication treatment plan. Instead, it is a
“prescribe-it-and-see” approach that has become the accepted
norm along with adjustments and a lot of guessing.
Unfortunately, a by-product of this trial-and-error process is
the patient’s loss of hope and confidence in taking their medica-tion,
which is an additional complication in pursuing sustainable
treatment. It’s a big healthcare issue because the perpetuation of
treatment results in greater loss of work performance, absentee-ism
and disability. This translates into higher medical costs and
employee turnover. The challenge is to determine the correct med-ication
and dose that would be effective and cause little or no
adverse reaction to employees and, ultimately, this will have a pos-itive
impact on business performance.
However, now we can take full advantage of PGx and, in the
process, be more precise and personalized in understanding and
developing both the pharmacological and clinical aspects of treat-ment
plans. This fills an important gap by taking the guesswork
out of the prescribing equation. It is now possible to determine,
with a high level of confidence, the appropriate drug, at the correct
dose, with minimum side effects.
This is exciting news for organizations and their insurance and
disability management providers. They recognize the value PGx
has on reducing healthcare costs, shortening the disability duration
period and improving treatment quality for employees. They are
now embracing the science and, according to a recent HRPA-P3
survey, making it available as part of the employee benefits plan.
Likewise, disability case managers are starting to recommend the
test as part of their return to work protocols.
Studies of PGx testing show that employees can better pinpoint
their prescription drug compatibility and increase adherence:
■■ Personalized Prescribing Inc., a cutting-edge pharmacogenomic
testing company that focuses on precision medicine, recently
completed an annual report on a pharmacogenomic test for an
organization that manages disability plans. It found that 86 per
cent of the employees referred by the disability managers had at
least one defective gene.
■■ A CAMH study on patients with a primary diagnosis of
depression or anxiety disorder showed that they received
maximum benefit from the treatment plan, recovered more
quickly and avoided potentially harmful side effects.
■■ A 2013 study published in Translational Psychiatry determined
that a pharmacogenetic test for employees on at least one of 26
commonly used antidepressant and antipsychotic medications
could reduce absent days three-fold and disability claims
■■ A study published by Nature Publishing Group in 2013
determined that a pharmacogenetic test could predict which
patients with obsessive-compulsive disorder would have
more failed medication trials, with greater rates of adverse
■■ A 2012 Mayo Clinic research study reported that giving
a pharmacogenetic test to patients with depression could
significantly reduce depressive symptoms.
■■ Another study projected that a six-gene PGx test could save,
on average, $5,188 per year in healthcare costs for individual
psychiatric patients who were not content with their
There are two main challenges when considering a PGx test
for employees. First, people may be apprehensive about taking a
genetic test since they fear it may reveal their predisposition to a
disease. Second, many may worry about confidentiality and pri-vacy
issues in terms of identity theft or discrimination.
42 ❚ DECEMBER 2018 ❚ HR PROFESSIONAL