Matching the Patient to the Most Effective Drug, Using DNA

By ACSH Staff — Apr 05, 2016
A potentially effective, but largely overlooked, approach to treating illness seeks to remove some of the guess work from patient care. Pharmacogenomics, which uses an individual's DNA, is a process that some doctors believe can better match a person with the most effective medication.
shutterstock_187967735 DNA via Shutterstock

A potentially effective, but largely overlooked, approach to treating illness seeks to remove some of the guess work from patient care, especially when it comes to how drugs interact with each individual.

The method is called pharmacogenomics, which some doctors are praising as a more tailored approach to the assignment of drugs, because it takes into account a patient's specific and unique genetic makeup.

Specifically, pharmacogenomics aims to use a person’s genetic profile, or DNA, to guide doctors in prescribing drugs that will work most effectively.

The reason for this is straightforward: people react differently to the same drug. But if a patient's specific makeup is first considered, doctors can better understand the condition and assess the chances of effectiveness before offering the prescription. And this process can be utilized with just a quick swab of the cheek, or prick of the finger.

A saliva or blood sample is then sent to a laboratory and assessed for key genetic variations. These variations act as indicators as to how one might respond to certain medications such as pain relievers, antidepressants, and blood thinners, among others.

Some practitioners and organizations are more skeptical — cautioning others to be leery. As The Wall Street Journal notes, "Some major medical associations, including the American College of Cardiology and the American Psychiatric Association, have been slow to endorse the testing, mainly because there are no large, randomized controlled trials showing the technique significantly improves patient care."

According to the American Medical Association, roughly just 20 percent of doctors order such DNA testing. That low figure may also have something to do with insurance coverage, since only some carriers cover the testing, which reportedly can cost from a few hundred dollars to $2,000.

Still, when individual response to medications ranges so dramatically, an objective approach using DNA can be very promising. What one patients finds in terms of treatment to be beneficial, another might find to be completely ineffectual, or worse, downright harmful. Pharmacogenomics has the potential to eliminate this altogether.

According to the United States National Library of Medicine, "many drugs that are currently available are 'one size fits all,' but they don’t work the same way for everyone. It can be difficult to predict who will benefit from a medication, who will not respond at all, and who will experience negative side effects."

Negative or adverse side effects are costly, and they remain as one of the leadings causes of hospitalizations and death in the country.

According to the Dept. of Health and Human Services, over 770,000 people are injured or die each year as a result of adverse drug events (ADEs) and "national hospital expenses to treat patients who suffer ADEs during hospitalization are estimated at between $1.56 and $5.6 billion annually."

It seems clear that given the potential benefits from genetic testing, more research on this promising topic can only be helpful. And if it eventually proven to be effective, this can help eliminate the oftentimes unreliable trial-and-error approach currently used by physicians.