Abstract:
OBJECTIVES:The objective of this project was to determine pharmacy cost savings and improvement in adherence based on a combinatorial pharmacogenomic test (CPGx ) in patients who had switched or added a new psychiatric medication after having failed monotherapy for their psychiatric disorder. RESEARCH DESIGN AND METHODS:The prospective project compared 1 year pharmacy claims between a GeneSight CPGx guided cohort and a propensity-matched control group. Patients were project eligible if they augmented or switched to a different antidepressant or antipsychotic medication within the previous 90 days. Following the medication switch or augmentation, pharmacogenomic (PGx) testing was offered to each patient's treating clinician. Pharmacy claims were extracted from the Medco pharmacy claims database for each patient (n = 2168) for 1 year following testing and compared to a 5-to-1 propensity-matched treatment as usual (TAU), standard of care control group (n = 10,880). MAIN OUTCOME MEASURES:Total pharmacy spend per member per year; adherence. RESULTS:Patients who received PGx testing saved $1035.60 in total medication costs (both CNS and non-CNS medications) over 1 year compared to the non-tested standard of care cohort (p = 0.007). PGx testing improved adherence compared to standard of care (ΔPDCCPGx = 0.11 vs ΔPDCTAU = -0.01; p < 0.0001). Pharmacy cost savings averaged $2774.53 for patients who were changed to a CPGx congruent medication regimen, compared to those who were not (p < 0.0001). CONCLUSIONS:PGx testing provides significant 'real world' cost savings, while simultaneously improving adherence in a difficult to treat psychiatric population. Limitations of this study include the lack of therapeutic efficacy follow-up data and possible confounding due to matching only on demographic and psychiatric variables.
journal_name
Curr Med Res Opinjournal_title
Current medical research and opinionauthors
Winner JG,Carhart JM,Altar CA,Goldfarb S,Allen JD,Lavezzari G,Parsons KK,Marshak AG,Garavaglia S,Dechairo BMdoi
10.1185/03007995.2015.1063483subject
Has Abstractpub_date
2015-01-01 00:00:00pages
1633-43issue
9eissn
0300-7995issn
1473-4877journal_volume
31pub_type
杂志文章abstract::Objective: To evaluate the risk of chronic kidney disease (CKD), cardiovascular disease (CVD), and osteoporotic fractures in human immunodeficiency virus (HIV) patients utilizing data within the Veteran's Affairs (VA) Administration system.Methods: A retrospective cohort study utilizing VA system claims (January 2000-...
journal_title:Current medical research and opinion
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journal_title:Current medical research and opinion
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journal_title:Current medical research and opinion
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journal_title:Current medical research and opinion
pub_type: 临床试验,杂志文章
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 临床试验,杂志文章,多中心研究
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1984-01-01 00:00:00