You may have heard the term “Precision Medicine” and wondered what it really means and how it can be applied to everyday life. There is one application to healthcare that empowers you to take control over your own health and well-being by allowing you to take a closer look at your prescription medications and how your body processes them. It is called “pharmacogenetics”, and it is giving healthcare providers evidence-based decision-making tools that help to tailor medications more precisely to a patient’s specific genetic makeup. So, what exactly does it do and how do you get a Pharmacogenetic Test in Canada?
What does it do for you?
A Pharmacogenetic (PGx) Test is a predictive tool – it reveals how a patient would respond to a medication before it is prescribed, helping doctors choose the most effective drug therapy quickly and more efficiently, resulting in safer, more effective treatments with fewer side effects and better health outcomes for their patients. It is a personalized approach that finds the right medication at the right dose, based on a person’s unique genetic profile for specific drug metabolizing enzymes. People who experience adverse side effects or a reduced response to their medication can benefit from PGx testing to find the optimal treatment for their condition. This type of genetic test for medication effectiveness has been available for a number of years.
PGx Tests are not identical. How do you choose the right test for your needs? There are a number of factors to consider:
1. Treatment areas that are covered by the PGx Test
Some PGx Tests are focused on just one treatment area, for example, only medications for mental health conditions. However, some PGx Tests, such as Pillcheck™, cover many of the most commonly prescribed medications in a variety of therapeutic areas, such as: cardiovascular disease; gastrointestinal conditions; mental health (antidepressants and antipsychotics); pain management; rheumatology and oncology. Since your DNA does not change, this broader scope ensures that your test report will be a useful reference for your current and future prescription needs.
2. Which CYP450 genes and other markers are tested
There are a number of important genes that control the metabolism and transport of medications in the body (i.e., how well the body processes and clears them). A comprehensive PGx Test should cover these markers: CYP2D6 (including copy number variants or CNVs); CYP2C9; CYP2C19; DPYD; TPMT; VKORC1; SLCO1B1; UGT1A1.
A truly comprehensive test will also include rare ethnic variants – forms of genes that tend to occur at high frequency within certain ethnic groups – an important factor if you happen to be a member of one of these groups.
3. What happens after you get your PGx Test results?
You have received your pharmacogenetic test results. Now what? Most companies do not offer support services beyond providing your test results. Pillcheck™ offers a support service that includes facilitating communication between you and your prescribing physician through a specially trained pharmacist.
4. Cost & Reimbursement
PGx Tests qualify for reimbursement through your Health Spending Account (HSA) if the service includes a review by a physician or pharmacist.
How do you get a Pharmacogenetic (PGx) Test in Canada? There are several ways:
- You can order it directly from a company that offers a PGx service by purchasing it online (Direct-to-Consumer approach)
- You can ask a healthcare practitioner to order it for you; specialists in certain healthcare clinics or hospitals can place an order for a PGx Test
- Some community pharmacies can order a PGx Test on your behalf as part of their comprehensive service, which may include facilitating a prescription change with your doctor (see an example here, where a community pharmacy in Toronto is now offering Pillcheck)
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