Pharmacogenetic-guided psychiatric intervention associated with increased adherence and cost savings.

Fagerness J, Fonseca E, Hess GP, Scott R, Gardner KR, Koffler M, Fava M, Perlis R, Brennan FX, Lombard J.

Abstract

OBJECTIVES:

Pharmacogenetic testing as a means of guiding treatment decisions is beginning to see wider clinical use in psychiatry. The utility of this genetic information as it pertains to clinical decision making, treatment effectiveness, cost savings, and patient perception has not been fully characterized.

STUDY DESIGN:

In this retrospective study, we examined health claims data in order to assess medication adherence rates and healthcare costs for psychiatric patients.

METHODS:

Individuals for whom pharmacogenetic testing was ordered (cases) were contrasted with those who did not undergo such testing (controls). Cases and controls were propensity score matched in order to minimize risk of confounding in this nonrandomized study. An initial analysis of 111 cases and 222 controls examined both adherence and healthcare costs. A replication study of 116 cases and 232 controls examined adherence alone, as cost data was not available for this latter cohort.

RESULTS:

Overall, individuals with assay-guided treatment were significantly more medication adherent (P = 1.56 3 10–3; Cohen’s d = 0.511) than patients with standard treatment and demonstrated a relative cost savings of 9.5% in outpatient costs over a 4-month follow-up period, or $562 in total savings.

CONCLUSIONS:

The data show the utility of pharmacogenetic testing in everyday psychiatric clinical practice, as it can lead to improved patient adherence and decreased healthcare costs.