Now, Riches says she hopes others can avoid the trial-and-error experience by undergoing genetic testing to predict which drugs will be most effective for them and have the fewest side effects. Masu.
These personalized treatments, known as pharmacogenomic testing, are available for a fee. The lab tests DNA from samples such as blood, saliva, and cheek swabs to identify genetic mutations that affect a patient’s metabolism or response to certain drugs.
Riches is one of three patients who took part in a University of British Columbia study on how much money could be saved if public funds were put into pharmacogenomic testing.
A study published Tuesday in the Canadian Medical Association Journal found that offering this test as part of standard care could save the entire health system in British Columbia alone $956 million over 20 years. It suggests something. This doesn’t include all the personal and financial savings that come from people returning to work, being able to afford childcare, and having a better quality of life.
Sterling Bryan, the study’s senior author, said there are more than 35 antidepressants available in Canada, but nearly half of patients do not respond to the first drug they are prescribed; reported intolerable side effects.
Brian, a professor in UBC’s School of Population and Public Health and a senior research fellow at the Vancouver Coastal Health Research Institute, said genes account for about 42 per cent of the differences in people’s responses to antidepressants.
Researchers accessed health data for approximately 194,000 patients from 2015 to 2020. This included drugs commonly prescribed for major depression and clinical trial data linking genetic information to appropriate antidepressants. From there, they developed a simulation model that compared how people would spend 20 years without a pharmacogenomics test, compared to the predictable outcomes of that test.
Brian said that approximately 37% of patients who do not respond to various medications are considered to have treatment-resistant depression, and in some cases they may abandon treatment due to frustration, at which point further medical attention, including psychotherapy, may be required. He said it is possible. You may also be hospitalized for electroconvulsive therapy (ECT) or other treatments, which can increase your medical costs.
“One in 10 Canadians will experience major depression in their lifetime,” Stirling said, adding that pharmacogenomic testing could cost billions of dollars across the country if it were widely available. I believe you can save money.
In addition to financial savings, Brian said the study showed an estimated 1,869 lives would be saved over 20 years.
Few patients undergo genetic testing to determine which antidepressant is best for them, but patients who choose that option usually do so by spitting into a tube and mailing it to a lab. increasing.
But doctors may not know how to interpret a person’s genetic profile to help make prescribing decisions, Bryan said, urging more education about it through programs that fund testing.
Research into pharmacogenomic testing is also underway elsewhere in Canada.
Dr. Paul Arnold, a child and adolescent psychiatrist and director of the Mattison Center for Mental Health Research and Education at the University of Calgary, said the study targeted patients aged six to 24 who are starting or looking to switch to medication. I am involved in research. Different medicine.
Arnold said DNA samples have been collected from about 1,000 patients in Alberta, British Columbia, Saskatchewan and Alberta, and the goal is to collect 2,000 more children and youth. .
The study originally included participants up to the age of 18, but because most mental illnesses begin before the age of 25, participants were expanded.
The samples are being tested by publicly funded laboratories, but the cost will ultimately be covered by the Alberta government, depending on the results after researchers analyze changes in prescribing patterns and health service utilization. Arnold said that is expected.
“The interesting thing about pharmacogenomic research is that you can see the effects right away,” he said. “The goal is to catch it early, before[patients]go through a journey of multiple medications that don’t work.”
Psychiatrist Dr. Jitender Sareen, medical director of the Winnipeg Regional Health Authority’s mental health program, determines the impact of pharmacogenomic testing on hospitalized adults, including older adults taking medications for multiple conditions. He said plans are underway to begin research on the topic. .
“While our goal is to recruit all adults, we want to start on inpatient wards, as there is mixed evidence about whether this type of pharmacogenomic testing can actually reduce length of stay. ” he said.
Pharmacogenomic testing currently costs between $200 and $400, but providing testing to everyone who needs antidepressants would benefit not only patients but also the health system and community caregivers. Saleen said that it would be possible.
“People get tired of trying different drugs, and this could at least guide treatment.”
This report by The Canadian Press was first published Nov. 14, 2023.
Canadian Press health coverage is supported through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
Camille Baines, Canadian Press
