Patient-Level Exposure to Actionable Pharmacogenomic Medications in a Nationally Representative Insurance Claims...

Area of Science:

• Pharmacogenomics
• Medication Exposure
• Health Services Research

Background:

• The widespread use of pharmacogenomic medications is known, but data on patient exposure duration is limited.
• Understanding medication exposure is crucial for optimizing pharmacogenomic testing and treatment strategies.

Purpose of the Study:

• To quantify patient-level exposure to actionable pharmacogenomic medications.
• To analyze medication exposure patterns in a large, nationally representative population using insurance claims data.

Main Methods:

• Retrospective cohort study utilizing the IQVIA PharMetrics® Plus for Academics claims database (2012-2018).
• Included adults with incident fills of 72 Clinical Pharmacogenetics Implementation Consortium (CPIC) level A, A/B, or B medications.
• Assessed patient-level outcomes including proportion of days covered (PDC), number of fills, and average days supplied per fill over 12 months.

Main Results:

• Over 1 million fills were analyzed for 605,355 unique patients.
• The mean PDC was 0.21 (77 days), indicating 21% annual exposure.
• Medications like ivacaftor, tamoxifen, clopidogrel, HIV, transplant, and statins showed higher PDC; most were initiated by fewer patients.

Conclusions:

• Male sex, older age, and comorbid chronic conditions were associated with increased medication exposure.
• Prescription fill data provide valuable patient-level metrics for understanding pharmacogenomic medication utilization.
• Findings can inform strategies for implementing and utilizing pharmacogenomic testing.