by brant bullard | Mar 23, 2016 | News
As the education of Pharmacogenomic Testing becomes more prevalent within the LTC arena, many questions have been raised as to the potential for “true savings” or “financial benefits” to testing.
Clay Bullard, President
PGx Medical
Several studies have been published that speak to both the clinical and financial benefits of utilizing testing. The goal of this article is to highlight several of these reference studies and their findings, all in an effort for CEO’s, DON’s and Physicians to potentially rethink some of their processes in Medication Management for LTC residents.
In 2014, the amount of money spent on prescriptions in the US was approximated to be $300 billion, with an estimated 6.3% annual increase according to Medicare and Medicaid data1. It is estimated that an additional $.50 is spent on Adverse Drug Reactions (ADR’s) for every $1 spent on the initial prescription. Polypharmacy dynamics increase significantly within the Elderly, specifically LTC residents, compounds additional costs associated with falls, hospitalizations, increased level of care, pain management and so on2-6.
Other studies have shown that implementing the PGx testing program can change referral rates and decrease mortality rates within LTC facilities. This can lead to higher census rates, better marketing efforts and staff efficiency7-8. A healthier patient population on fewer medications, and lower mortality rates, should provide a positive value proposition for any LTC facility Owner, CEO, Physician, or care provider to consider.
Additionally, one study has shown the value of testing to decrease patient treatment cost by over 60% in a clinic setting9. In the hospital setting, studies show the true impact to care providers, as hospital length of stay was three times longer with twice the amount of hospital charges/cost for patients who had an ADR and intermediate metabolization of their 2D6 gene10. Implementing Metabolic Validation testing early in the care process is key to provide clinical and financial benefit11.
In summary, the argument that there is not data to support the value proposition for a program that costs an LTC facility $0 to implement, has now been eliminated. We are very excited to have an overwhelming amount of clinical and statistical data that supports the “real world” feedback we receive daily from clinicians in facilities all over the United Sates. These data points validate the clinical and financial impact the program has had and can have in an LTC facility.
We hope every facility will ask the simple question, “Is our facility doing everything we can do to offer the best opportunities for quality of life for your residents?”
For more information, contact:
PGx Medical
info@pgxmed.com
405-509-5112
References:
- (Centers for Medicare and Medicaid Services. Available from: https:// www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends- and Reports/NationalHealthExpendData/Downloads/proj2014.pdf. CMS; 2013. Accessed November 27, 2015.)
- SgangaF,LandiF,RuggieroC,etal.Polypharmacyandhealthoutcomes among older adults discharged from hospital: Results from the CRIME study. Geratr Gerontol Int. 2015;15(2):141–146.
- 10. Runganga M, Peel NM, Hubbard RE, et al. Multiple medication use in older patients in post-acute transitional care: a prospective cohort study. Clin Interv Aging. 2014;9:1453–1462.
- 11. Garfinkel D, Mangin D. Feasibility study of systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Arch Intern Med. 2010;170(18):1648–1654.
- 12. Garfinkel D, Zur-Gil S, Ben-Israel J. The war against polypharmacy: a new cost- effective geriatric-palliative approach for improving drug therapy in disabled elderly people. Isr Med Assoc J. 2007;9(6): 430–434.
- Winner J, Allen JD, Altar CA, Spahic-Mihajlovic A. Psychiatric phar- macogenomics predicts health resource utilization of outpatients with anxiety and depression. Transl Psychiatry. 2013;3:e242.
- Garfinkel D, Mangin D. Feasibility study of systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Arch Intern Med. 2010;170(18):1648–1654.
- 12. Garfinkel D, Zur-Gil S, Ben-Israel J. The war against polypharmacy: a new cost- effective geriatric-palliative approach for improving drug therapy in disabled elderly people. Isr Med Assoc J. 2007;9(6): 430–434.
- Herbild L, et al. Does Pharmacogenetic Testing for CYP450 2D6 and 2C19 Among Patients with Diagnoses within the Schizophrenic Spectrum Reduce Treatment Costs? Basic & Clin Pharmacol&Toxicol 2013; doi10.1111/bcpt.12093.
- Chou WH, et al. Extension of a Pilot Study: Impact From the Cytochrome P450 2D6 Polymorphism on Outcome and Costs Associated With Severe Mental Illness. J Clin Pyschopharmacol 2000;20(2):246-251.
11. Saldivar JS, Taylor D, Sugarman EA, Cullors A, Garces JA, Oades K, Centeno J; Initial assessment of the benefits of implementing pharmacogenetics into the medical management of patients in a long-term care facility; Dove Medical Press, 19 January 2016 Vol2016:9 Pages 1-6
by brant bullard | Mar 22, 2016 | Journal articles
MTM and Pharmacogenomic Testing…a perfect fit
Blair Green Thielemier, PharmD
Pharmacy Times
Genetic testing has come a long way since completion of the project. Now pharmacists and physicians can use pharmacogenomic test results to help choose safer and more effective medications for their patients. An article posted on Crain’s Chicago Business website featured a physician clinic in Illinois that is doing preemptive genotyping: NorthShore University’s HealthSystems clinic is building a program that will screen patients and use DNA test results to guide therapies.
Another recent study, this one published in the Journal of Medical Economics and conducted at the University of Utah, used cytochrome P450 pharmacogenetic profiling in clinical decision making for elderly patients. The study results found that the hospitalization rate of the genotype-tested group was 6.3 percentage points lower than the untested cohort: 9.8% versus 16.1%, respectively. The estimated potential cost savings was $218 (mean) in the genotype-tested group.2 The study also found that among the health care providers of the genotype-tested group, 95% of providers found the test “helpful” and 46% followed the clinical decision support tool recommendations for therapy changes. The Mayo Clinic is conducting similar studies on the effectiveness of preemptive genotyping, developing clinical decision-making support tools of its own and planning integration of test results into its electronic medical record (EMR).
No one understands medication management better than a pharmacist. So why not help guide them by determining upfront which medications a patient can actually metabolize? A simple swab of the cheek can help lower healthcare costs and improve the quality of life for our seniors.
Read entire article at: pharmacytimes.com
For more information on pharmacogenomic testing, or how you can implement pharmacogenomics, contact:
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
by brant bullard | Mar 17, 2016 | Metabolic Validation Program
PGx Medical is proud to partner with Brookdale Senior Living!
Rose Willingham, Wellness Director
Brookdale Senior Living Norman
On October 14, 2014 I heard PGx Medical President, Clay Bullard speak in Tulsa at the State Provider Training meeting. Pharmacogenetics was the only thing I took away from the seminar. I wrote Clay’s name down and went back and spoke to our doctors about doing the test.
I had several residents at the time on 3-4 blood pressure medications that I knew would benefit from something like this. I remember thinking, if this test can get them off of some of their meds and help prevent falls, that’s what I need to do. When something is wrong, you always look at the medications. And when someone is on three pages of meds and they are tiny, you start to wonder what is going on.
I was so impressed with Clay’s talk that I came back and told Dr. Dellinger about the program. He has always been so receptive to anything I talk to him about, so I asked Dr. Dellinger if he had ever heard about the test. He said a little, but not a lot. I told him I really want to try it and see if we can get some of our residents off medications they don’t need to be on and get them on the right medications. He said, “It sounds great! Check into it for me.”
I called PGx Medical and one of their consultants came out right away and explained the program to us. Dr. Dellinger started writing orders for me and I began testing. I also have a couple of physicians outside the facility that the residents still go out to see and they have started testing their residents as well.
We’ve been using the Metabolic Validation Program (pharmacogenetic testing) for about two years and now we test all of Dr. Dellinger’s patients with medical necessity. Dr. Dellinger comes in every two weeks and knows everything about the residents, he’s great!
I have one resident who wasn’t metabolizing any of her medications. That is one of those residents who was on three pages of medications. She was on all the wrong ones. We made some tweaks and it’s amazing, her hallucinating went away. She doesn’t hallucinate anymore and she sleeps better too. She is doing well now!
We have another lady who liked to take things away from other people. Then she quit eating. We did the test, got her on the right medications, and she did so well after we made changes to her meds that we were able to discharge her back out into the community. She was just doing that well. She is now living at home with no problems. It was the medication changes and finding the one that she metabolized and worked for her.
The majority of Dr. Dellinger’s residents that we’ve tested, we’ve made changes and tweaked and they are doing so much better. There are none that we have tested that it hasn’t worked on.
It’s great, we love it, and I will tell anyone they need to do it!
For more information on Metabolic Validation, via Pharmacogenetic Testing, contact:
PGx Medical
info@pgx.med.com
405-509-5112
www.pgxmed.com
by brant bullard | Mar 5, 2016 | Careers
Independent contractors with Nursing Home, Home Health or Hospice relationships needed across the country. Looking for self-starters who have the desire to succeed in a fast paced, growing industry. This is a great opportunity!
All interested candidates can submit resume to: info@pgxmed.com
Potential candidates will be contacted to schedule a phone interview
by brant bullard | Mar 3, 2016 | News
Maintaining a healthy mind, body, and spirit is as important to the caregiver as it is older adults.
Making sure your elderly family member is taking the right medications is important to getting them up, out and active.
A recent survey of 17,000 Medicare beneficiaries found that 2 out of 5 patients reported taking five or more prescription medicines.
According to Drugwatch.com, adults 65 and older often take multiple medications, both prescription and over-the-counter (OTC) drugs. When people take more than one drug at the same time, it is called polypharmacy. While medications are intended to improve lives and relieve symptoms, in some cases they cause more problems.
Older adults may also fail to take the drugs in the proper way because they lose track of them, and sometimes certain drugs may interact with each other, causing additional symptoms and health problems.
By 2030, about 72 million people will be 65 or older. Today’s seniors live longer than before, which makes it important to make your extra years as fun-filled and pain-free as possible.
Adverse reactions attributable to prescription drug use cause an estimated 100,000 deaths and more than two million serious reactions in the United States each year, costing the healthcare industry more than $136 billion annually.
The PGx Medical Metabolic Validation Program can help reduce unnecessary medications and the risk for adverse drug reactions (ADR). A simple swab of the cheek can tell your healthcare provider what medications your body is able to metabolize which eliminates the trial and error process. This test can improve clinical outcomes and reduce the overall cost of prescription drugs by enabling better drug selection, earlier favorable results and lower rates of ADRs.
For more information, contact PGx Medical at (405) 509-5112 or info@pgxmed.com. www.pgxmed.com
