Canadian Medication Cost Savings Associated with Combinatorial Pharmacogenomic Guidance for Psychiatric Medications
Received 3 August 2019
Accepted for publication 22 November 2019
Published 9 December 2019 Volume 2019:11 Pages 779—787
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Samer Hamidi
Julie-Anne Tanner,1,2 Lisa C Brown,3 Kunbo Yu,3 James Li,3 Bryan M Dechairo4
1Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, Department of Psychiatry, Toronto, ON, Canada; 2Assurex Health Ltd., Toronto, ON, Canada; 3Assurex Health, Inc., Mason, OH, USA; 4Myriad Genetics, Inc., Salt Lake City, UT, USA
Correspondence: Julie-Anne Tanner
Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Department of Psychiatry, Assurex Health, Ltd., 250 College, Room R38, Toronto, ON M5T 1L8, Canada
Tel +1 416 813-2745
Objective: To estimate Canadian pharmacy cost savings associated with psychiatric medication prescribing that is guided by combinatorial pharmacogenomic testing in patients switching or augmenting their psychiatric medication.
Methods: Pharmacy claims data from a United States (US) pharmacy benefit manager were analyzed for 1662 patients who recently augmented or switched to a different antidepressant or antipsychotic medication and underwent combinatorial pharmacogenomic testing. Costs of prescription medications were translated to the Canadian healthcare system by matching drug names and doses using the Ontario Drug Benefit Formulary. One-year costs (2017 CAD) were compared between patients whose clinician prescribed antidepressants or antipsychotics that were consistent (congruent) or inconsistent (incongruent) with the combinatorial pharmacogenomic test recommendations.
Results: Patients whose psychiatric medication treatment was congruent with the combinatorial pharmacogenomic test report saved $1061 CAD per member per year (PMPY) on prescription medication costs relative to patients whose medications were incongruent with their test report (p<0.0001). For patients ages 99% matched at the therapeutic chapter.
Conclusions: Antidepressant and antipsychotic prescribing that was congruent with combinatorial pharmacogenomic test guidance was associated with significant cost savings on Canadian prescription medications according to the Ontario Drug Benefit Formulary.
Keywords: pharmacogenomics, genetic test, genesight, psychiatry, mental health, prescription, pharmacy spend
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