Pharmacogenomics (PGx) is the study of how genes affect a response to a particular medication. PGx is a tool used to personalize medication regimen since not all medications work the same in every person. For a medication to work, enzymes have to break the drug down so your body can absorb it and have an effect. Pharmacogenomics tests the functionality of a person’s enzyme. For example, if a person is taking Tramadol, which is a prodrug (inactive) and the enzyme needed to break it down (CYP2D6) is a slow metabolizer, the therapeutic effect which is pain relief might not be achieved. An increase in dose by taking an additional pill might still not have the effect and it might even cause unwanted side effects. In this situation, an alternative medication may be needed.
The genetic makeup of a person does not change, therefore, this test needs to only be done once.
The test is done with a special Q-tip to swab the cheeks. There is not needles or blood work involved. At the bottom of this Q&A is a link that shows how the test is done.
The provider of service is the one who can order the test. Just like other laboratory tests or blood work that needs a lab form to be ordered and signed by a provider.
It can take from 3-5 business days to get the results for domestic service in the United States; however, for international testing service, it can take longer.
Everyone is eligible to take the test.
Medicare covers the test with no copay if there is indication to test. Some United HealthCare plans and Medicaid (depending on your state) may also cover genomic testing. Other commercial insurance may cover the test and a pre-authorization is recommended to verify coverage.
Yes. If your insurance does not cover the test and you want to pay out of pocket, you are still able to get the test done. Included in the cost are: A face-to-face meeting with a pharmacogenomics certified pharmacist to go over all your medications and health history, determine your eligibility for the test.
Also, the international service is out of pocket and it is only cash.
The result of the genomic test can be over 30 pages long depending on the complexity of the medication regimen. We narrow that down to a 1-page recommendation summary and send to the ordering provider. The provider can share the results and provide a copy to the patient as they see fit.
Other labs utilize sales reps that drop off kits to doctor offices and allow the staff to order the supplies and do their own testing. The provider receives over 30 pages of genomics results which requires the knowledge to use the raw that into an actionable clinical decision. That can take time away from the doctor in a busy practice setting. Our company has certified pharmacogenomics pharmacists providing the kits, performing the test, and narrowing down the many pages to what is relevant to the patient. We do the work for you so your practice does not have to.