Taylor Mirfendereski | WCPO Cincinnati | January 29, 2015
MASON, Ohio Finding the right medicine to treat depression is largely trial and error. But now with the swab of a Qtip, a Mason-based company is helping doctors nationwide choose medicine that are genetically proven to work best on each patient.
Assurex Health is a personalized medicine company built around gene profiling technology licensed from the Mayo Clinic and Cincinnati Children’s Hospital Medical Center. Its chief product, GeneSight Psychotropic, is a test that analyzes how a person’s genes might affect the way their body responds to medicine commonly prescribed to treat depression, posttraumatic stress disorder (PTSD), anxiety, bipolar disease, schizophrenia or other behavioral health conditions.
The results of the cotton swab DNA test tell doctors what medicines appear to not interfere with their patients genetic profile, the medicines with the potential to interfere with it and those that are incompatible with a patient’s genetic makeup. While there’s no guarantee the medicine will always work, the test is clinically proven to double the chances that it will.
“Trying to find the right medication is like trying to find a needle in the haystack. What GeneSight does is it removes a lot of the hay,” said Bryan Dechairo, senior vice president of Assurex’s medical affairs and clinical development. It’s the first psychiatric test of its kind to get a nod from the federal government. Medicare decided in October to cover the $3,800 test for the 52 million Americans that it insures. The Department of Veteran Affairs added GeneSight to the federal supply schedule in June.
That doesn’t mean the VA is widely using it to treat depression or PTSD just yet. It does mean its psychiatrists can order it. The technology could be the much needed solution for those who’ve struggled to find a medicine they can tolerate without unwanted side effects like nausea, weight gain and sexual dysfunction.
And perhaps most urgently, for those who haven’t found a medication that works at all. It usually takes four to eight weeks for doctors to know what’s working and what’s not. Most major insurance companies cover it and the copay ranges from $0 to $500 on average, Dechairo said.
“That’s a long time for someone to wait, particularly if they are severely depressed,” said Erik Nelson, a University of Cincinnati Medical Center psychiatrist, who has used the test on patients before.
“They’re going to take the [medicine]. They’re going to feel nauseous and they’re going to stop taking the medication….These patients start really just downward spiraling and feeling even worse and worse depressed. There’s a risk of suicide,” said Assurex’s Dechairo.
Treating Depression A Bit Hit-And-Miss
Doctors traditionally prescribe behavioral health medication by asking the patient a series of questions about their family history and medical history. Doctors usually have go to drugs that work for most people, and that’s often what they’ll prescribe first.
“There are studies that show us that in large groups of people certain drugs work better than other drugs. But with individuals, there’s a variability, and a certain level of good luck and guessing. Some people metabolize differently and some don’t respond. That’s the trial and error part,” said Stephen Strakowski, a psychiatrist at UC Medical Center who hasn’t used it in his practice.
The Genesight test is designed to be used when a person hasn’t responded appropriately to one or more behavioral health drugs doctors prescribe. That’s something all too common when treating mental health conditions, experts say.
“This [test] is huge because we know, for instance, in the field of depression that the failure rate on antidepressants is very high. Once you fail on one antidepressant, the likelihood of failing on a second is even higher. It’s something that we’ve struggled with when you have to take multiple medication changes to get something right,” said Kathleen Chard, director of the trauma recovery center at the Cincinnati VA and a psychologist at UC Medical Center.
The GeneSight test consists of two 10-second cotton cheek swabs to collect the patient’s DNA. Doctors send the samples to the Assurex laboratory overnight, and the company promises to return the results within 36 hours.
About a dozen employees receive and input information from about 300 to 400 cotton swab samples every day before the DNA is enhanced for testing, said senior laboratory director Nina King.
More than 130,000 patients have now used the test.
Test Tripled Company Growth
King was one of the first people on board the company, back when just a handful of employees worked out of a laboratory housed inside an old karate studio that looked like garage.
“I really cannot believe that that happened. It’s incredible growth that we went from seven employees to 250 and still growing, and hiring,” said King. “It’s surreal honestly.” The now 240employee company has tripled its employment in the last three years and quadrupled the number of patients that have taken the GeneSight test.
Assurex has attracted more than $50 million in investment capital and a top-tier management team that includes CEO Gina Drosos, a former group president for Procter & Gamble Co., and Dechairo, a geneticist whose 20-year business career has included high-ranking posts at Pfizer Inc. and Medco.
Just last week, the company announced plans to remain in Mason as it expands its headquarters with a new 60,000 square foot building. The company is currently based in a 10,000 square foot space at the Mason Community Center. It leases another 15,000 square feet for a laboratory and call center in Mason’s Municipal Center building.
Saving Patient’s Money
Dechario said the company’s research has proven the test can save patient’s money in the long-term and reduce other related medical-related issues that can impact quality of life.
In one economic study, their research concluded that patients who had been on medications that GeneSight found to collide with their genetic profile had 69 percent more health care visits than those were on compatible medications. They also had three times more medical absence days from work and four times the number of disability claims.
“Our test would have predicted that those patients would have been the worst patients, and of course, those patients over the course of one year had those problems because they were on medication the doctor prescribed them that was simply not right for them,” Dechario said.
Assurex has developed two additional GeneSight tests used for different purposes. GeneSight ADHD is designed to help doctors select personalized medication for Attention Deficit Hyperactivity Disorder and GeneSight Analgesic analyzes how a patient will respond to pain medications. Neither test is covered by Medicare or on the federal supply schedule.
WCPO’s Dan Monk contributed to this story.