Decision-makers urged to put personalized medicine into action

Pharmacogenomics can change the way patients are treated, according to a presentation at the Academy of Managed Care Pharmacy's 2011 Educational Conference, in Atlanta.

Pharmacogenomics is the use of genomic tests to select appropriate treatments for patients with the goal of achieving optimal drug therapy and dosage. Personalized medicine uses genetic or other molecular biomarkers to improve effectiveness, safety, and dosing in patients using a targeted stratification, by identifying potential responders/non-responders, and those at risk for adverse drug reactions.

This testing could potentially improve medicine benefit/risk ratio. These drugs/tests include those for oncology, and for HIV treatment, including: trastuzumab, lapatinib, and HER2 testing; erlotinib and EGFR testing; interferon and ribavirin and IL28B genotyping; maraviroc and CCR5 tropism tests; warfarin and CYP2C9/VKORC1 tests; and clopidogrel with CYP2C19 testing.

Healthcare providers need to seek out education in order to develop expertise, acccording to Lawrence Lesko, PhD, FCP, professor and director of the Center for Pharmacometrics and Systems Pharmacology at the College of Pharmacy, University of Florida at Lake Nona, Orlando, Fla. "There are still a lot of questions about who is evaluating the quality and clinical utility of genetic tests. In managed care, the best approach for the most effective application of personalized medicine still needs to be elucidated," he said.

Decision-makers can make a difference in clinical outcomes and the quality of patient experiences with their medication regimens, Dr Lesko added. "We know enough about the pharmacogenomics of drugs such as warfarin and clopidogrel now to put personalized medicine into action. I encourage all professionals to take advantage of pharmacogenomic opportunities; indeed, patients expect it. There still appears to be a chasm between science and practice."