Why pharmacogenetic testing should be reimbursed by Medicare and commercial health insurance

Abstract

It is well documented in the field of psychiatry that pharmacogenomic testing improves patient care by providing physicians a tool to accurately monitor patient compliance and tolerance to certain drugs and their dosages. For example, in guidelines promulgated by several organizations including the Food and Drug Administration (FDA) list the pharmacogenomics testing that should be performed when prescribing psychiatric drugs such as amitriptyline. Among the CYP450 metabolizing enzymes with variants is CYP2D6, responsible for the metabolism of drugs such as oxycodone. The field of pain medicine could also benefit from the use of pharmacogenomics testing for opioid management but has been stymied by lack of support by government and commercial entities that label these tests as, at best “experimental” and at worst, outright fraudulent.