Pharmacogenetics: What is it, and what does it have to do with your benefits?

November 28, 2019 3:58 pm




1. the branch of pharmacology concerned with the effect of genetic factors on reactions to drugs

What you need to know about pharmacogenetics

Pharmacogenetics: Have you heard this new term being mentioned in different health discussions? It’s one of the latest evolutions in drug tests, and it has now reached the group benefits arena. This advance now enables testing to determine a person’s genes’ response to a drug, before actually taking the drug.

Pharmacogenetics is the study of inherited genetic differences in our drug metabolic pathways. It’s one of those differentiating factors that impacts one person’s response to a drug versus another’s. So, while doctors previously prescribed on the basis of age, gender, weight, liver and kidney function, pharmacogenetics enables doctors to select the best medication and dose for a given patient using genetic data. Doctors can now identify genes that cause serious side effects, and as a result, can avoid such outcomes by determining if their patient has a specific gene. It’s thanks to the sharing of scientific results from institutes that have, for many years, studied the effects of genes and medications that we have this advance in pharmacogenetic testing.

When pharmacogenetic testing makes sense

The use of pharmacogenetic testing is becoming a very helpful tool for individuals for whom higher-cost drugs are prescribed as an option to improve outcomes. In fact, in the group benefits arena, some carriers are beginning to implement this testing as part of their process.

Costs for pharmacogenetic testing (PGx) range from $250 to $500, based on our research in Canada. You can request a PGx test from an online provider, or you can ask a healthcare professional to order the test. Some pharmacies may assist in ordering this test when a physician has requested a change in prescription. Some group benefit plans may even cover the cost when a doctor requests the test, depending on a plan’s laboratory diagnostic testing coverage. Healthcare Spending Accounts (HCSA) should allow this expense when it is requested by a physician. Best to inquire with your provider, in advance, what restrictions and coverage are provided in your plan.

It’s important to be aware of this evolution in testing, especially when you may be struggling with finding the right drug for a condition. Where group benefits are concerned, don’t be surprised if you get asked to participate in this type of testing before a carrier confirms acceptance of a high cost drug; the goal being to get the right drug at the right time for the right person.

For more information on what pharmacogenetic testing means to your group benefit experience, please contact Rosemary Marsh at 905-777-9990, ext. 202 or via email at Our expertise is your advantage!

This post was written by Rosemary Marsh

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