The effect of pharmacogenetic profiling with a clinical decision support tool on healthcare resource utilization and estimated costs in the elderly exposed to polypharmacy

Journal of Medical Economics

Volumn 19, Issue 3, 2016, Pages 213-228

  Brixner, D ^a   Biltaji, E ^a   Bress, A ^a   Unni, S ^a   Ye, X ^a   Mamiya, T ^b   Ashcraft, K ^b   Biskupiak, J ^a  

^a UNIVERSITY OF UTAH   (United States)

^b Genelex Corporation   (United States)

Author keywords

Adverse drug events; CYP2C19; CYP2C9; CYP2D6; CYP3A4; CYP3A5; Cytochrome; Drug interactions; Drug metabolizing enzymes; Geriatrics; Health resource utilization; Pharmacogenetic testing; Polypharmacy

Indexed keywords

CARVEDILOL; CELECOXIB; CITALOPRAM; CLOPIDOGREL; CYTOCHROME P450; DIAZEPAM; ESCITALOPRAM; HYDROCODONE; MELOXICAM; METOPROLOL; OMEPRAZOLE; PAROXETINE; SERTRALINE; VENLAFAXINE;

ADULT; AGED; ARTICLE; CLINICAL DECISION MAKING; COHORT ANALYSIS; COST CONTROL; DECISION SUPPORT SYSTEM; DRUG COST; EMERGENCY CARE; FEMALE; HEALTH CARE UTILIZATION; HOSPITALIZATION COST; HUMAN; MAJOR CLINICAL STUDY; MALE; OBSERVATIONAL STUDY; OUTPATIENT CARE; PHARMACOGENETICS; PHYSICIAN ATTITUDE; POLYPHARMACY; PROSPECTIVE STUDY; CLINICAL DECISION SUPPORT SYSTEM; COMPARATIVE STUDY; ECONOMICS; GENETICS; HEALTH CARE COST; HEALTH CARE PLANNING; HOSPITAL EMERGENCY SERVICE; HOSPITALIZATION; ORAL DRUG ADMINISTRATION; PROPENSITY SCORE; UTILIZATION;

ADMINISTRATION, ORAL; AGED; CYTOCHROME P-450 ENZYME SYSTEM; DECISION SUPPORT SYSTEMS, CLINICAL; EMERGENCY SERVICE, HOSPITAL; FEMALE; HEALTH CARE COSTS; HEALTH RESOURCES; HOSPITALIZATION; HUMANS; MALE; PHARMACOGENETICS; POLYPHARMACY; PROPENSITY SCORE; PROSPECTIVE STUDIES;

EID: 84959160554     PISSN: 13696998     EISSN: 1941837X     Source Type: Journal    
DOI: 10.3111/13696998.2015.1110160     Document Type: Article

References (50)

1. PharmGKB®. U.S. Department of Health & Human Services. CPIC Genes/Drugs. Stanford, CA, 2015. https://www.pharmgkb.org/cpic/pairs. Accessed 4 September 2015
2. U.S. Food and Drug Administration. FDA announces new boxed warning on Plavix. FDA News Release. Silver Spring, MD, 2010. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm204253.htm. Accessed 2 September 2015
3. Scott SA, Sangkuhl K, Stein CM, et al. Clinical Pharmacogenetics Implementation Consortium guidelines for CYP2C19 genotype and clopidogrel therapy: 2013 update. Clin Pharmacol Ther 2013; 94: 317-23
4. Hicks JK, Swen JJ, Thorn CF, et al. Clinical Pharmacogenetics Implementation Consortium guideline for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants. Clin Pharmacol Ther 2013; 93: 402-8
5. Ramsey LB, Johnson SG, Caudle KE, et al. The clinical pharmacogenetics implementation consortium guideline for SLCO1B1 and simvastatin-induced myopathy: 2014 update. Clin Pharmacol Ther 2014; 96: 423-8
6. Hicks JK, Bishop JR, Sangkuhl K, et al. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6 and CYP2C19 genotypes and dosing of selective serotonin reuptake inhibitors. Clin Pharmacol Ther 2015; 98: 127-34
7. Schildcrout JS, Denny JC, Bowton E, et al. Optimizing drug outcomes through pharmacogenetics: a case for preemptive genotyping. Clin Pharmacol Ther 2012; 92: 235-42
8. Villagra D, Goethe J, Schwartz HI, et al. Novel drug metabolism indices for pharmacogenetic functional status based on combinatory genotyping of CYP2C9, CYP2C19 and CYP2D6 genes. Biomark Med 2011; 5: 427-38
9. Hamburg MA, Collins FS. The path to personalized medicine. N Engl J Med 2010; 363: 301-4
10. Bushardt RL, Massey EB, Simpson TW, et al. Polypharmacy: misleading, but manageable. Clin Interv Aging 2008; 3: 383-9
11. Berenbeim DM. Polypharmacy: overdosing on good intentions. Manag Care Q 2002; 10: 1-5
12. Verbeurgt P, Mamiya T, Oesterheld J. How common are drug and gene interactions Prevalence in a sample of 1143 patients with CYP2C9, CYP2C19 and CYP2D6 genotyping. Pharmacogenomics 2014; 15: 655-65
13. U.S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research (CDER), Center for Biologics Evaluation and Research (CBER), Center for Devices and Radiological Health (CDRH). Clinical pharmacogenomics: premarket evaluation in early-phase clinical studies and recommendations for labeling-Guidance for Industry. Silver Spring, MD, 2013. http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm337169.pdf. Accessed 17 September 2015
14. Preskorn SH, Kane CP, Lobello K, et al. Cytochrome P450 2D6 phenoconversion is common in patients being treated for depression: implications for personalized medicine. J Clin Psychiatry 2013; 74: 614-21
15. Hohl CM, Dankoff J, Colacone A, et al. Polypharmacy, adverse drug-related events, and potential adverse drug interactions in elderly patients presenting to an emergency department. Ann Emerg Med 2001; 38: 666-71
16. Berg ML, Estes LL, Dierkhising RA, et al. Evaluation of impact of statin use on development of CPK elevation during daptomycin therapy. Ann Pharmacother 2014; 48: 320-7
17. D'Avolio A, Ciancio A, Siccardi M, et al. Negative predictive value of IL28B, SLC28A2, and CYP27B1 SNPs and low RBV plasma exposure for therapeutic response to PEG/IFN-RBV treatment. Ther Drug Monit 2012; 34: 722-8
18. Marcus RK, Geurts JL, Grzybowski JA, et al. Challenges to clinical utilization of hereditary cancer gene panel testing: perspectives from the front lines. Fam Cancer 2015; 14: 641-9
19. Enchin H. Clinician adoption of genetic testing for drug metabolizing enzymes: is patient safety the low-hanging fruit of personalized medicine AMIA Annu Symp Proc 2009; 2009: 168-72
20. Corporation G. Personalized Prescribing system. Seattle, WA, 2014. http://youscript.com/. Accessed 4 September 2015
21. Inovalon Inc. Medical Outcomes Research for Effectiveness and Economics Registry (MORE2 Registry). Bowie, MD, 2015. http://www.inovalon.com/howwehelp/more2-registry. Accessed 1 September 2015
22. Department of Health and Human Services, Centers for Medicare and Medicaid Services. Point of Origin Codes Update to the UB-04 (CMS-1450) Manual Code List. Baltimore, MD, 2009. https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1775CP.pdf. Accessed 1 September 2015
23. AHRQ. Hospital Inpatient Services-Mean and Median Expenses per person with expense and distribution of expenses by source of payment: United States, 2012. Medical Expenditure Panel Survey Household Component Data. Rockville, MD, 2012
24. Weiss A, Elxiharser A. Overview of hospital stays in the United States, 2012. Rockville, MD, 2012. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb180-Hospitalizations-United-States-2012.pdf. Accessed 1 September 2015
25. National Center for Health Statistics, Centers for Disease Control. National Ambulatory Medical Care Survey: 2010 Summary Tables. Atlanta, GA, 2010. http://www.cdc.gov/nchs/data/ahcd/namcs-summary/2010-namcs-web-tables.pdf. Accessed 1 September 2015
26. Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika 1983; 70: 41-55
27. Austin PC. Goodness-of-fit diagnostics for the propensity score model when estimating treatment effects using covariate adjustment with the propensity score. Pharmacoepidemiol Drug Saf 2008; 17: 1202-17
28. D'Hoore W, Bouckaert A, Tilquin C. Practical considerations on the use of the Charlson comorbidity index with administrative data bases. J Clin Epidemiol 1996; 49: 1429-33
29. Faulkner E, Annemans L, Garrison L, et al. Challenges in the development and reimbursement of personalized medicine-payer and manufacturer perspectives and implications for health economics and outcomes research: a report of the ISPOR personalized medicine special interest group. Value Health 2012; 15: 1162-71
30. Meckley LM, Neumann PJ. Personalized medicine: factors influencing reimbursement. Health Policy 2010; 94: 91-100
31. Alagoz O, Durham D, Kasirajan K. Cost-effectiveness of one-time genetic testing to minimize lifetime adverse drug reactions. Pharmacogenomics J 2015. [Epub ahead of print]. doi: 10.1038/tpj.2015.39
32. Swen JJ, Wilting I, de Goede AL, et al. Pharmacogenetics: from bench to byte. Clin Pharmacol Ther 2008; 83: 781-7
33. Wyatt JE, Pettit WL, Harirforoosh S. Pharmacogenetics of nonsteroidal anti-inflammatory drugs. Pharmacogenomics J 2012; 12: 462-7
34. Hughes CA, Foisy MM, Dewhurst N, et al. Abacavir hypersensitivity reaction: an update. Ann Pharmacother 2008; 42: 387-96
35. Johnson SG, Gruntowicz D, Chua T, et al. Financial analysis of CYP2C19 genotyping in patients receiving dual antiplatelet therapy following acute coronary syndrome and percutaneous coronary intervention. J Manag Care Spec Pharm 2015; 21: 552-7
36. Winner JG, Carhart JM, Altar CA, et al. Combinatorial pharmacogenomic guidance for psychiatric medications reduces overall pharmacy costs in a 1 year prospective evaluation. Curr Med Res Opin 2015; 31: 1633-43
37. Centers for Disease Control and Prevention. Medication safety basics. Atlanta, GA, 2012. http://www.cdc.gov/medicationsafety/basics.html. Accessed 4 September 2015
38. Beijer HJ, de Blaey CJ. Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studies. Pharm World Sci 2002; 24: 46-54
39. Pirmohamed M, James S, Meakin S, et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18,820 patients. BMJ 2004; 329: 15-19
40. Budnitz DS, Pollock DA, Weidenbach KN, et al. National surveillance of emergency department visits for outpatient adverse drug events. JAMA 2006; 296: 1858-66
41. Bayoumi I, Dolovich L, Hutchison B, et al. Medication-related emergency department visits and hospitalizations among older adults. Can Fam Physician 2014; 60: e217-22
42. Khoury M, Little J, Burje W. Human genome epidemiology: a scientific foundation for using genetic information to improve health and prevent disease. New York: Oxford University Press, 2004
43. Herman L, Froelich J, Kanelos D, et al. Utility of a genomic-based, personalized medicine test in patients presenting with symptoms suggesting coronary artery disease. J Am Board Fam Med 2014; 27: 258-67
44. Mukherjee A, Rakha EA. Integrating breast cancer genetics into clinical practice. Womens Health (Lond Engl) 2012; 8: 99-112
45. Baranov VS. Genome paths: a way to personalized and predictive medicine. Acta Naturae 2009; 1: 70-80
46. Janssens AC, Deverka PA. Useless until proven effective: the clinical utility of preemptive pharmacogenetic testing. Clin Pharmacol Ther 2014; 96: 652-4
47. Deverka PA, Haga SB. Comparative effectiveness research and demonstrating clinical utility for molecular diagnostic tests. Clin Chem 2015; 61: 142-4
48. Van Driest SL, Shi Y, Bowton EA, et al. Clinically actionable genotypes among 10,000 patients with preemptive pharmacogenomic testing. Clin Pharmacol Ther 2014; 95: 423-31
49. Patterson R, Oesterheld JO. Genetic data analysis and database tools. US Patent #US8311851. Mountain View, CA, 2012. www.google.com/patents/US8311851. Accessed 14 October 2015
50. Patterson R, Oesterheld JO. Genetic data analysis and database tools. US patent #US8099298. Mountain View, CA, 2012. http://www.google.com/patents/US8099298. Accessed 14 October 2015