Knowledge of pharmacogenomics—a collection of genomic factors contributing to individual variability in response to drug therapy—enhances the ability to diagnose, prevent, and treat disease. Although understanding the correct application of pharmacogenomics may be essential to providing cost-effective care, barriers include the absence of provider knowledge and inappropriate reimbursement strategies. Angela Luong, PharmD, and colleagues at OPTUMInsight conducted a survey of pharmacists regarding their knowledge of genetic testing and utilization strategies.
A total of 19 pharmacists at 4 different managed care organizations responded to the survey, revealing a basic lack of knowledge of pharmacogenomics (or personalized medicine). The majority of respondents (84%) agreed or strongly agreed that pharmacogenomics will have an impact on healthcare expenditures and that pharmacists should have a good knowledge base of pharmacogenomics-related drug therapies and tests; however, the majority (84%) did not routinely have much education in this area. Overall, 95% of participants scored <60% on a pharmacogenomics knowledge test.
In addition, knowledge of pharmacogenomics does not necessarily have a direct impact on patient care or benefit design. Only 47% (n = 9) of respondents said their plan requires prior authorization (PA) for the use of the US Food and Drug Administration–approved companion diagnostic test for vemurafenib compared with 58% (n = 11) of respondents whose plans require a PA for the companion test for crizotinib. By contrast, only 16% (n = 3) of respondents said their plans require testing for HER2 mutation before prescribing trastuzumab compared with 58% (n = 11) of respondents whose plans do not require testing and 26% (n = 5) who did not know whether their plans require such testing.
Furthermore, the majority of respondents did not know whether their plans had reimbursement policies related to pharmacogenomics. Overall, this survey reveals gaps in pharmacists’ knowledge of pharmacogenomics utility and its related benefit design strategies. As a result of the growing impact of personalized medicine and tests for pharmacogenomics, understanding and designing appropriate benefit policies are essential; the group at OPTUMInsight plans on continuing this research with a larger pharmacist population. [Luong A, Lal L, King K, et al. Assessment for clinical utility of currently available oncology genetic tests and assessment of pharmacogenomics knowledge of pharmacists.]