Right Drug, Right Dose, also known as Pharmacogenomic Testing, was a four part series I Blogged on in August 2016. I never would of thought it would be available at a pharmacy near you this soon. Benefits Canada has just announced an association between myDNA and a genetic interpretation service based in Melbourne, Australia.
The question is are all Pharmacogenomic Testing created equal?
According to PillCheck and Ruslan Dorfman from Geneyouin not all tests are equal.
“Although the consumer price of $269 looks attractive, we would like to warn pharmacist and patients about the inadequate test sensitivity, and high risk of false negative results produced by these tests.
The disclosed genotyping panel used by the MyDNA includes only 25 markers, which results in poor assay sensitivity, particularly in the ethnically diverse Canadian population. Such panel was optimized for cost efficiency to include only the most common markers present in Caucasians. However, markers that are common in Native Canadians, Blacks, East Asians, Arabs, and Ashkenazi Jews are missing. Therefore, these minorities are likely to receive false negative results, leading to incorrect clinical decisions.
Below is a comparison between Pillcheck and myDNA tests:
| Pillcheck | myDNA.life |
| Offering Pillcheck test both as DTC available online or at retail pharmacy | Test is available only through accredited retail pharmacies in Australia due to regulatory restrictions on DTC testing |
| Test includes 168 biomarkers CYP2C9, CYP2C19, CYP2D6, SLCO1B1, TMPT, DPD, UGT1A1, VKORC1, CYP3A4, COMT, SLC4A6, CYP2B6, IL28B and other genes. | Test includes only 25 markers in CYP2C9, CYP2C19, CYP2D6, CYP1A2, CYP3A4, CYP3A5, SLCO1B1 and VKORC1
|
| Selection of reported drugs determined by the FDA drug labeling information, and CPIC guidelines, and is rapidly expanding in scope to ensure lifetime value for the patient, enable accurate decision making for the healthcare providers, and improve the ROI for payers. | Selection of reported drugs is limited due the minimalistic genotyping panel. |
| 100+ commonly prescribed medications
(115 in March 2017) |
Not disclosed, but probably reports contains 40-50 medications with CPIC guidelines. |
| Can provide insights for specialty medications and oral oncology | Missing many clinically-relevant medications,
Significant risk of incorrect recommendations due to low sensitivity test. |
| Selection of markets to maximize sensitivity and relevance for ethnic minorities | Minimal set of makers relevant primarily for Caucasians, high false negative rate for ethnic minorities |
| Reports delivered in PDF or structured data (RESTful API); can be configured to integrate with decision-support in pharmacy or EMR | Reports delivered through GuideCare software application. |
| $499 including pharmacist consult, both online and retail pharmacist environment | $269 “full test”, including pharmacist consult only in retail setting |
Ruslan Dorfman and Geneyouin, strongly believe that “cheap” tests do not provide better value for the patient and the healthcare providers. 23andme and myDNA tests might seem more affordable options, but utilization of these tests is likely to reduce the clinical and health value of pharmacogenetics and should be used with caution.”
Are we on the right path or will this test cause more harm? Make sure you have the right test for your body make up.
Glendinning Insurance Services