Swab solutions: Price drop of genetic test boosts its popularity

EDMOND – Dr. Stuart Schrader has a new method to improve the way he prescribes drugs. The owner of Crossway Medical Clinic uses a genetic test to understand how a patient metabolizes some medications, tailoring prescriptions for individuals.

The test allows Schrader to quickly identify the best drug to prescribe for patients who suffer from chronic blood and heart conditions, rather than a trial-and-error basis, he said. It also is more effective in determining drug interactions and is better than using a physician’s desk reference, he said.

Clay Bullard, CEO of PGX Medical, designed the test and works with physicians to recommend its use. A simple cheek swab gathers information for a lab in California to examine 19 genes. Those genes are commonly associated with arthritis pain; anxiety, depression and psychosis; high blood pressure and high cholesterol; attention deficit hyperactivity disorder; and other conditions.

Pharmacogenetic testing has been around for about 19 years, but recently the cost for genetic testing dropped dramatically, he said. Bullard had the idea to develop the company when his wife’s physician recommended the test about 10 years ago. She wasn’t getting results from her rheumatoid arthritis treatment, and the doctor said the genetic screening could better determine which medicine would work well for her.

Bullard said he hoped more doctors will choose the test, particularly for the geriatric population. He is working with the state Department of Health to educate nursing home owners about the test, as a way to reduce the number of psychotropic drugs taken by people in assisted living centers.

Yet geriatric researcher Mark Stratton disagrees that the test is useful for a broad swath of the elderly. The University of Oklahoma College of Pharmacy professor wrote in an emailed statement to The Journal Record that pharmacogenetic testing research is an emerging area, but evidence doesn’t yet support that testing for geriatric patients.

That type of genetic testing is useful for patients with potentially terminal illnesses, such as AIDS or breast cancer, whose diseases have not otherwise responded to typical treatment, Stratton wrote. Pharmacogenetic screening provides one piece of information in a very complex medical situation, and a patient’s response to medication is affected by more than one’s genes, he wrote.

Schrader said the test has been useful for geriatric patients to determine the minimal dose for chronic conditions. In addition, the test has been effective for patients who suffer from migraine headaches and haven’t responded to typical treatment, he said. In four months he’s recommended the test for more than 200 patients at his primary care practice in Oklahoma City.

For patients whose conditions haven’t been successfully treated with commonly prescribed medications, the test is important to help convince the patient to allow him to continue looking for the right drug, Schrader said.

“When one type of medication didn’t work well and they’ve given up on that class of drugs entirely, we can show them they can work with these genetic tests,” he said. “We can help ease the anxiety and show how the medicine will metabolize in the body.”