Combinatorial approach improves medication adherence and reduces polypharmacy in patients treated with antidepressants and antipsychotics
MASON, Ohio — (August 12, 2015) – A new study published in Current Medical Research and Opinion demonstrated $1,036 in annual prescription savings per patient when healthcare providers used the GeneSight® combinatorial pharmacogenomic (CPGx) test results to guide treatment decisions compared with usual trial-and-error prescribing. CPGx is the evaluation of multiple genetic factors that influence an individual’s response to medications.
Unlike other tests, GeneSight measures multiple clinically important genomic variants for each patient and weights them together – rather than one at a time – to provide comprehensive genetically driven recommendations for each medication for each patient. This is important in evaluating medication response given that most psychiatric medications work through multiple genetic pathways, both metabolically and at their point of response. GeneSight is the only neuropsychiatric pharmacogenomic test available that is based on proprietary and patented combinatorial technology.
The study, based on data from more than 13,000 patients being treated for behavioral health issues, analyzed whether CPGx improves adherence and leads to cost savings. The study found that:
- Patients receiving a GeneSight test averaged savings of $1,036 per year in pharmacy costs alone compared to traditional prescribing methods;
- Annual savings were substantial, regardless of whether patients were treated by psychiatrists, physicians in primary care practices, or other healthcare professionals;
- Neuropsychiatric combinatorial pharmacogenomic (CPGx) testing improved patients’ adherence to the prescribed treatment by 17 percent;
- Polypharmacy was reduced with one out of five patients being prescribed fewer medications after receiving GeneSight testing.
The study compared pharmacy claims over a one year period between a patient group whose treatment was guided by GeneSight and a propensity-matched control group whose treatment was decided using traditional prescribing methods.
“The results of this analysis reinforce the existing clinical evidence that using the GeneSight Psychotropic test to guide treatment decisions saves significant money,” said lead author Dr. Joel Winner, president of Winner Psychiatry in Boulder, Colorado, and medical director of Assurex Health.
GeneSight is the only neuropsychiatric pharmacogenomic test covered by Medicare and available through the U.S. Department of Veterans Affairs, and proven in multiple peer-reviewed, published clinical studies to result in better patient outcomes at lower cost through enhanced medication selection.
Mental Illness Direct Treatment Costs Among the Highest
Direct treatment costs for mental illness far exceed those for diabetes and hypertension, and lag only behind cardiovascular disease, traumatic injury, and cancer.i Indirect treatment costs also are staggering, with major depressive disorder (MDD) responsible for the highest disability costs among all major illnesses.ii The National Institute of Mental Health reports that annual direct and indirect costs for depression are $200 billioniii with annual psychiatric medication costs of $30.3 billioni.
One in four adults suffers from a mental illness in any given year.iv MDD is one of the most common among these illnesses with a one year prevalence of 6.7 percent.iv Many individuals suffering from MDD do not receive treatment because of social stigma, financial outlay, and limited access to healthcare.iv Of those who do pursue treatment, two-thirds do not achieve full remission. Instead, they often end up on a pharmacologic odyssey requiring multiple failed medications to ultimately find a medication with a favorable risk/benefit balance.v
This perpetuation of treatment-resistant depression results in greater loss of work productivity and disability, and 70 percent higher annual medical costs than for treatment-responsive patients.vi
Study Analyzes Significant Patient Population
The study compared pharmacy claims over one year between a prospectively generated cohort of GeneSight tested subjects (n = 2,168) and a 5-to-1 clinically and demographically matched control group (n = 10,880) selected from a pool of approximately 65 million eligible Medco plan members. Patients were eligible for either group if they were newly starting an antidepressant or antipsychotic medication, or were augmented or switched to a different antidepressant or antipsychotic medication and maintained continual pharmacy benefits eligibility from six months prior to the initial prescription to the date of the new medication.
Both groups were followed for one year. Prescription medication claims data were analyzed for differences between the two groups and within the GeneSight group based on medication changes that were consistent or inconsistent with each participant’s GeneSight results.
“The size of the study, significant health care cost savings and increased adherence by patients are compelling,” said Gabriela Lavezzari, AVP, Scientific & Regulatory Affairs at PhRMA, formerly of Medco Health Solutions. “It is evident that GeneSight precision medicine testing can offer a true benefit to patients and to their prescribing physicians.”
The full study is available at http://genesight.com/medcostudy.
GeneSight helps health care providers make more precise treatment decisions based on how a patient’s unique genetic makeup affects their individual response to 38 FDA-approved medications for depression, anxiety, posttraumatic stress disorder (PTSD), bipolar disorder, schizophrenia and other mental health conditions. GeneSight is the only neuropsychiatric combinatorial pharmacogenomic test validated in multiple, peer-reviewed, published clinical studies. GeneSight analyzes over 785,000 permutations of an individual’s genes and available medications, and presents the results in an easy to read, color-coded report available typically within 36 hours after Assurex Health receives a patient’s cheek swab. Many commercial and government insurance plans, including Medicare and the U.S. Department of Veterans Affairs, reimburse all or part of the cost of GeneSight. Assurex Health also offers financial assistance programs for patients who qualify.
About Assurex Health
Assurex Health is a commercial-stage, informatics-based precision medicine company providing treatment decision support to health care providers for behavioral health conditions. Assurex Health’s proprietary GeneSight technology is based on combinatorial pharmacogenomics (CPGx™) – the application of multiple genetic factors that influence an individual’s response to medications – as well as evidence-based medicine and clinical pharmacology. Assurex Health has licensed patented technology from Mayo Clinic and Cincinnati Children’s Hospital Medical Center, both of whom continue to be research collaborators.
i Agency for Health care Research and Quality. Total Expenses and Percent Distribution for Selected Conditions by Type of Service: United States, 2011. Medical Expenditure Panel Survey Household Component Data. Generated interactively. (October 20, 2014).
ii Mrazek DA, Hornberger JC, Altar CA, Degtiar I. A review of the clinical, economic, and societal burden of treatment-resistant depression: 1996-2013. Psychiatr Serv. 2014;65(8):977-87.
iii National Institute of Mental Health: Annual Total Direct and Indirect Costs of Serious Mental Illness (2002) .(29 July 2010) “Annual Total Direct and Indirect Costs of Serious Mental Illness (2002)” Retrieved from http://www.nimh.nih.gov/health/statistics/cost/index.shtml
iv NAMI. Numbers of Americans Affected by Mental Illness. Mental Illness Facts and Numbers http://www.nami.org/factsheets/mentalillness_factsheet.pdf. Accessed October 20, 2013.
v Warden D, Rush AJ, Trivedi MH, Fava M, Wisniewski SR. The STAR*D Project results: a comprehensive review of findings. Curr Psychiatry Rep. 2007;9(6):449-59.
vi Mrazek DA, Hornberger JC, Altar CA, Degtiar I. A review of the clinical, economic, and societal burden of treatment-resistant depression: 1996-2013. Psychiatr Serv. 2014;65(8):977-87.