Multi-Gene Pharmacogenomic Testing in a Community-Based Setting Is Feasible and Reduces Total Healthcare Costs

Area of Science:

• Pharmacogenomics
• Health Economics
• Clinical Pharmacy

Background:

• Pharmacogenomic (PGx) testing, particularly multi-gene panels (mgPGx), is known to enhance clinical outcomes.
• Real-world data on the economic impact of mgPGx testing is limited.
• Understanding the economic value of mgPGx is crucial for widespread clinical adoption.

Purpose of the Study:

• To evaluate the utility and economic value of mgPGx testing in Medicare patients within a community health system.
• To assess the prevalence of PGx medications, polypharmacy involving PGx drugs, and actionable PGx results.
• To compare the Total Cost of Care (TCOC) between patients who underwent mgPGx testing and a matched control group.

Main Methods:

• A cohort of 1042 Medicare Advantage patients in a community health system underwent mgPGx testing.
• A stratification algorithm identified patients taking at least one PGx-guided medication.
• Propensity score matching was used to compare TCOC over 12 months for 548 tested patients and a control group.

Main Results:

• 44% of patients were on three or more PGx-guided medications.
• Over one-third of these patients (35.5%) had at least two actionable PGx results.
• A trend towards net cost savings of $1827 per member per year was observed, including medical and pharmacy savings.

Conclusions:

• Polypharmacy involving PGx medications is common in this patient population.
• mgPGx testing demonstrated a trend toward significant cost savings.
• Further research with larger sample sizes is warranted to confirm these economic findings and assess long-term impacts.