Pharmacogenomics: Precision Pharmacy in 503A Compounding

The first recorded mention of a pharmacogenomic response may be that of Pythagoras in 510 BC, when he noted that hemolytic anemia developed in some but not all people who ingested fava beans. The application of such accounts to pharmacotherapy was inevitable, and customized medications have been compounded since antiquity to treat the needs of individual patients. Today, advances in pharmacogenomic testing yield results that enable more effective targeted therapies sooner in the course of treatment, prevent drug-related adverse effects, save cost, and ensure a better therapeutic outcome. The value of such testing is now more widely accepted, even in the public domain. It is our opinion that third-party payors will realize, to an increasing degree, that this new technology will save them money and will pay for it. Because independent compounding pharmacists have trusted relationships with patients and are convenient to visit, they are well placed to offer certain types of pharmacogenomic tests to patients and prescribers. In this article, topics that we address include the difference between pharmacogenomics and pharmacogenetics; the use of pharmacogenomic testing in 503A compounding; the benefits of such tests for patients, prescribers, and compounders; and suggestions for marketing pharmacogenomics testing. Information about a course that introduces pharmacogenomic science to compounders is provided, and suggestions for additional reading and other resources about pharmacogenomic testing are included for easy reference.