Topic: Preemptive Pharmacogenetic Testing: Exploring the Knowledge and Perspectives of United States Payers
Speaker: Nicholas J. Keeling, PhD Candidate, University of Mississippi School of Pharmacy
Preemptive pharmacogenetic testing aims to improve the safety and efficacy of medications by using genetic information to inform drug prescribing. Further investigation is needed to describe the position of the payer stakeholder on preemptive pharmacogenetics, as their coverage and reimbursement decisions will impact the adoption of this technology. This presentation will summarize a qualitative study using semi-structured, in-depth interviews to was to investigate payer’s knowledge, awareness, and perspectives on preemptive pharmacogenetic testing.
Three major themes were identified. First, payers understood the potential benefits for patients and the health system from preemptive pharmacogenetic testing, but further demonstrations of clinical utility were needed. Second, the idea of widespread testing without the ability to definitively project downstream economic benefits was a barrier to adoption. Finally, population health implications for the possibility of using pharmacogenetics as a preventive service and role of other stakeholders, such as the FDA and CMS, were mentioned frequently.
Payer’s limited exposure to preemptive pharmacogenetics and its potential benefits gave pause to rapid adoption of this approach to optimize drug therapy. Furthermore, a payer’s ability to judge the value of preemptive pharmacogenetics may be limited by their cost-benefit tradeoff determination, often made on a one-year budget cycle. The ability to enable and influence clinician prescribing based on genetic data in Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines was viewed as a valuable resource.