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J. Pers. Med. 2018, 8(4), 32; https://doi.org/10.3390/jpm8040032

The Implementation Process for Pharmacogenomic Testing for Cancer-Targeted Therapies

1
PRecisiOn Medicine Translational Research (PROMoTeR) Center, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, 401 Park Drive, Suite 401, Boston, MA 02215, USA
2
Meyers Primary Care Institute, 385 Grove Street, Worcester, MA 01605, USA
*
Author to whom correspondence should be addressed.
Received: 14 September 2018 / Revised: 25 September 2018 / Accepted: 26 September 2018 / Published: 1 October 2018
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Abstract

Recent advances in genomic medicine have led to the availability of genomic tests that have the potential to improve population health, yet the process for obtaining these tests and getting them reimbursed by insurers has not been described. The objective of this study was to describe the process of ordering pharmacogenomic tests by interviewing providers, patients, and laboratories about cancer-related pharmacogenomic tests. We interviewed patients who were prescribed, providers who prescribed medications that should be guided by pharmacogenomic testing, and individuals from diagnostic laboratories. A total of 10 providers, 16 patients, and eight diagnostic laboratories described logistical and insurance issues relating to ordering and receiving pharmacogenomic tests and medications. We found that the process of ordering pharmacogenomic tests is time-consuming, expensive, and complex. Ordering pharmacogenomic tests is quite different across institutions. Even in the same institution, multiple providers can order the test. Once the provider places the order for the pharmacogenomic test, the laboratory receives the request and usually begins testing without knowing how the test will be paid for. Next, the laboratory completes the pharmacogenomic testing and the results of the tests are reported to providers, patients, or placed directly in the medical record. In conclusion, processes related to ordering and obtaining insurance coverage for pharmacogenomic tests varies greatly across institutions and is time-consuming. View Full-Text
Keywords: pharmacogenomics; implementation; cancer pharmacogenomics; implementation; cancer
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Wu, A.C.; Mazor, K.M.; Ceccarelli, R.; Loomer, S.; Lu, C.Y. The Implementation Process for Pharmacogenomic Testing for Cancer-Targeted Therapies. J. Pers. Med. 2018, 8, 32.

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