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What do you offer your residents that other homes don’t?
Are you doing everything you can to provide the best healthcare and personalized care for your residents?
In a recent article on Senior Housing Forum, the author states, “From my perspective this is a win-win opportunity for every senior community, every resident and every physician. Better healthcare for your residents, reduced drug costs and a unique marketing tool for your communities.”
So let me ask you, if you could offer your residents personalized medicine that would improve their quality of life, would you do it?
Pharmacogenetics isn’t new but it is just now gaining the attention of healthcare professionals – especially in senior communities where the majority of residents are on multiple medications.
What makes this work in senior communities is that medicare and many senior HMO’s realize that this tool will save them money so they will cover the “once in a lifetime” test. The PGx Metabolic Validation Program has demonstrated that 25%-40% of residents would benefit from the test and be treated with a different medication based on Metabolic Validation.
The PGx Metabolic Validation Program is simple. On the physicians orders, a quick swab is taken of the inside of the resident’t mouth. Once the swab is analyzed and a report is generated, the physician can treat that resident on a personal basis. The report allows physicians to know which classes of drugs will be most effective, and the data can also provide guidance on dosage.
This test is no different than any other lab work and is kept in the residents file to help improve their quality of life and decrease the “trial & error” process. Which makes it very accepting for families and a unique marketing tool for homes. Better care and personalized attention.
For more information, or to schedule an implementation meeting, contact:
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
Are Your Residents Receiving the Right Drugs?
So here is the scenario:
Your residents are seen by their physicians who then prescribe medications based on that resident’s signs and symptoms and the drugs do what they are supposed to do right?
Real Life
It turns out in real life it is not that simple because not all drugs or classes of drugs are metabolized the same with the same effectiveness in all people. What this means is that you could have two residents with the same signs and symptoms, the same lab values and the same doctor and yet for one resident the medication works great and the other not so great or in some cases not at all.
In fact it is likely that right now in your skilled nursing community or assisted living community some significant percentage of your residents are taking medications that are either not working at all or not working as well as they should.
Why this is Important to you and your residents
- The resident, their family and your staff assume a medication is working when it may not be working. This could mean delays in getting prescribing an effective drug or even worse a substantial degradation of a residents health
- Money and time is wasted on sub-optimal medications during “trial and error” process
- Prescribing the wrong medication means extra physician visits and laboratory costs
- Skilled nursing communities get tagged for not meeting psychotropic drug reduction targets
Solving the Problem
Until PGx Medical reached out to me I confess I was ignorant to both the problem and by extension that there is a cool, painless, easy and cost effective solution to the problem. It turns out there is a simple painless genetic test called Metabolic Validation that gives physicians the guidance they need to validate existing drug regiments are the best for each resident and for prescribing the right medications individually, metabolically.
The test involves taking a simple quick swab of the inside of a resident’s mouth. The swab is analyzed and a report is generated for each resident that allows physicians to know which classes of drugs will be most effective. The data can also provide guidance on dosage.
The Cost – The Cost – The Cost
What makes doing this in your skilled nursing or assisted living community really cool is that Medicare and many Senior HMO’s have figured out that doing this test is both good for residents and can save buckets of money which is why they will cover the cost of the test (once in a lifetime, because Metabolic Validation is a DNA test). The testing done through PGx has demonstrated that 25% – 40% of residents would be better served with a different medication based on Metabolic Validation.
What Metabolic Validation ultimately does is provide a definitive answer to this question:
Does this medication have a realistic chance of being therapeutic for this resident based on their metabolic profile?
From my perspective this is a win-win opportunity for every senior community, every resident and every physician. Better healthcare for your residents, reduced drug costs and a unique marketing tool for your communities. You can learn more about Metabolic Validation at the PGX website, or by calling 405-509-5112 or email info@pgxmed.com to request more information.
Read full article at Senior Housing Forum
FDA Black Box Warning
What is a Black Box Warning?
Boxed Warning:
This type of warning is also commonly referred to as a “black box warning.” It appears on a prescription drug’s label and is designed to call attention to serious or life-threatening risks.
The FDA (Food and Drug Administration) approves a drug for marketing after determining that the drug’s benefits outweigh the risks for the condition that the drug will treat.
But even with a rigorous evaluation process, some safety problems surface only after a drug has been on the market and has been used in a broader population.
Adverse drug reaction:
An adverse drug reaction (ADR), also called a side effect, is any undesirable experience associated with the use of a medicine in a patient. Adverse events can range from mild to severe. Serious adverse events are those that can cause disability, are life-threatening, result in hospitalization or death, or are birth defects.
The Black Box Warning is the strongest warning that the FDA requires. This warning is reserved for prescription drugs that pose a significant risk of serious or life-threatening adverse effects, based on medical studies. The Black Box Warning is included in the labeling or medical information of the prescription drug. Search Drug specific index
PGx Medical has implemented the Metabolic Validation Program (Pharmacogenetic Testing) in hundreds of clinics and homes across the country. This program helps reduce the risk of adverse drug reactions, maximize drug efficacy and individualize drug dose.
Pharmacogenetics uses information (such as DNA sequence, gene expression, and copy number) for purposes of explaining inter individual differences in drug metabolism (pharmacokinetics) and physiological drug response (pharmacodynamics), identifying responders and non responders to a drug, and predicting the efficacy and/or toxicity of a drug. Eliminating the “trial & error” process and improving quality of life.
For more information on the PGx Metabolic Validation Program, contact:
PGx Medical
info@pgxmed.com
405-509-5112
Pharmacogenomics: Improving Dosing and Decreasing Adverse Events
Pharmacogenomics is the science of determining how genetic variability influences physiological responses to drugs, from absorption and metabolism to pharmacologic action and therapeutic effect. With increasing knowledge of the molecular basis for a drug’s action has come the recognition of the importance of an individual’s genetic makeup in influencing how he or she may respond to a drug.
Genetic variants in drug metabolizing enzymes can have a significant effect on the way a person responds to a drug. They can speed up or slow down enzymatic activity, or even inactivate an enzyme. In some patients, known as rapid metabolizers, drugs are metabolized too quickly. As a result, the average dose of the drug may be broken down too quickly to be effective, and a higher dose may be needed. Conversely, where the metabolite of the drug is active, as in the case of codeine (see below), rapid metabolism may lead to excessive accumulation of the active metabolite, which may result in toxic levels. In slow metabolizers, a drug administered at the recommended dose can accumulate due to such slow metabolism, potentially reaching toxic levels in the patient’s system and leading to adverse reactions. Such patients may require a smaller dose. In conjunction with other factors, pharmacogenomics offers the potential to enable doctors to identify the patients who are rapid or slow metabolizers of certain drugs and to adjust dosing accordingly to achieve both effective and safe treatment.
- Rapid metabolizers may break down a drug too quickly and require higher doses.
- Slow metabolizers may build up toxic levels of the drug and require smaller doses.
Clinical Applications of Pharmacogenomics
Warfarin (Coumadin and generics), an anticoagulant, is a recent example of the clinical use of pharmacogenomics to improve dosing. Warfarin has a narrow therapeutic window and a wide range of inter-individual variability in response, requiring careful clinical dose adjustment for each patient. Genetic variants in the warfarin target, the vitamin K epoxide reductase (VKORC1), as well as the warfarin metabolizing enzyme, cytochrome P450 2C9 (CYP2C9), influence the variation in patient response. Patients with certain variants of these genes eliminate warfarin more slowly and typically require lower warfarin doses. In those individuals, a traditional warfarin dose would more likely lead to an elevated International Normalized Ratio (INR), a longer time to achieve a stable warfarin dose, and a higher risk of serious bleeding events during the induction or dose-titration period of warfarin therapy. (FDA News)
Another recent example involves ultrarapid metabolizers of codeine, who have multiple copies of the gene for cytochrome P450 2D6 (CYP2D6), the enzyme that converts codeine into morphine, its active metabolite.
Tests to identify the three genetic polymorphisms for warfarin, codeine, and carbamazepine described above are commercially available.
Read more at FDA.com
For more information on the PGx Metabolic Validation Program, contact:
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
Personalized Medicine and Cost
At PGx Medical, our goal is to assist clients with our unique tools and programs to determine how to best incorporate and implement Pharmacogenetic testing within their clinic, company, pharmacy and center.
You like the program and you see the benefit of personalized medicine – but what does it cost?
Money and time is wasted on the “trial and error” process. And patient quality of life suffers in the interim. Poor metabolizers mean extra physician visits, laboratory and medication costs.
The PGx Metabolic Validation Program has demonstrated that 25%-40% of residents would be better served with a different medication based on Metabolic Validation. So the money saved by this “once in a lifetime test” is reason why many coverage types are reimbursing the cost.
While there isn’t a standard answer to the question of cost, what we do know is this program is definitely a cost saving long-term to both the patient and the provider. But more importantly, it improves the quality of life.
The PGx Metabolic Validation Program is currently implemented in hundreds of medical clinics and homes across the country. And our clients have confirmed…
- Helps reduce costs and improve care.
- Helps decrease the number of “unnecessary drugs” based on individual patient metabolic validation.
- And most importantly, helps deliver the most precise, personalized, validated level of therapy and care for each of the patients tested.
If you would like to learn more about how you can implement this cost saving program in your facility, or you would like more information on the program, contact us at:
PGx Medical
Individualized Care – Personalized Medicine
Info@pgxmed.com
www.pgxmed.com
405-509-5112
Can Genetic Testing be the Answer for Pain Relief?
Studies have shown that approximately $300 billion is wasted each year on drugs that do not work in people who carry certain genes.
While some people never receive the full benefit from these drugs, others experience dangerous side effects.
In order to treat individuals who have had many failures with drugs, some doctors are turning towards personalized medicine – which provides a method by which doctors can customize medication regimens so that they are effective from the start.
What role does genetics have in pain?
Research shows that genetic factors account for a substantial proportion of all elements contributing to a patient’s response to drugs (others include age, sex, weight, general health and liver function).
Genes provide your body with instructions for making enzymes, which help break down drugs in your system, allowing your body to benefit from the medicine. Differences in your enzymes can affect how your body metabolizes a drug and how long the drug stays your body – and thus, how well drugs may work in an individual.
In particular, common pain medications require activation by an enzyme called CYP2D6 to become effective. Approximately half of patients have genes that alter the function of CYP2D6. Testing for these gene alterations allows for changes to dosage regimens in order to compensate for altered metabolisms – and optimizes the safety and efficacy of pain medications.
Without knowing an individual’s specific genetic code, physicians may often need to go through months of trial-and-error prescribing to find the right drug and dose. Physicians are often baffled when a drug will work for one person but not for another with the same diagnosis. The fact of the matter is that physicians really do not know how to predict drug effectiveness or toxicity because everyone is different. Genetic testing helps assess drug responsiveness. An individual’s genes can be a map that serves as a guide for physicians.
What is Pharmacogenetic Testing (PGT)?
A simple saliva test can evaluate an individual’s ability to metabolize or process drugs. Pain medications such as hydrocodone, oxycodone, diazepam and morphine utilize the CYP2D6 enzyme in order to metabolize the drug. As a drug gets metabolized, it is broken down into harmless pieces and eventually cleared. The activity of your clearance system is based on your genetic code. Once tested, this knowledge about an individual’s unique drug metabolizing system can help guide physicians.
What is the purpose of PGT?
Physicians would like to be able to anticipate how one may respond to a drug instead of relying on a trial-and-error process. By knowing the specific way one may break-down drugs, a physician can tailor treatment according to an individual’s unique metabolism and immediately find the right drug. Not only will this information help physicians predict which drug will best treat pain, a physician will also be able to predict the effective dose and potential for toxicity. In theory, this knowledge has the potential to save time, money and lives.
Pharmacogenetic testing (PGT), specifically, is exceedingly important for the proper management of pain because finding the precise drug and dose for each patient is so critically important. The groundbreaking development of PGT testing provides more individualized drug treatment for patients while also reducing adverse effects.
What if someone is an ultra-rapid metabolizer?
Ultra-rapid metabolizers break down medications really fast. Individuals who often receive medications that do not work or frequently need double doses of medication in order to relieve pain may be ultra-rapid metabolizers.
What if someone is a poor metabolizer?
Poor metabolizers tend to have severe side effects at low doses. Instead of going through one medication trial after another only to get sick every time, this test allows physicians to determine whether or not someone is a poor metabolizer, and act accordingly.
When is testing appropriate?
Undergoing genetic testing is a once in-a-lifetime experience because your genes do not change over time. Since many drugs are metabolized by one enzyme, you may only need one test. Once you are tested, you can keep your genetic test results for the rest of your life and share them with future care professionals. If one uses several medications (polypharmacy) and/or if several medications have failed to work properly, PGT may be appropriate to consider.
The Bottom Line:
Pharmacogenetic testing is now available with most physician pain specialists. The results of these genetic tests may help doctors: adjust the dose of medications more efficiently, prescribe medications that will work properly and give the patient the full benefit of the drug. It can also help people avoid medications that may be more likely to cause dangerous side effects and will often save money for patients in the long run. Drug responses don’t have to be a mystery now that treatments can be tailored to custom fit an individual’s specific genetic code.
By: Dr. Anita Gupta is an Award Winning Johns Hopkins Trained Anesthesiologist, Pain Specialist, Pharmacist & Editor. She currently is Associate Professor & Medical Director at Drexel University-College of Medicine in Philadelphia, PA. Read entire article at Foxnews.com
For more information on how you can implement Genetic Testing in your company, clinic, pharmacy or home, contact:
PGx Medical
Individualized Care – Personalized Medicine
Info@pgxmed.com
405-509-5112