Pharmacogenomics (PGx) Program

One size does NOT fit all:  

Have you ever wondered why a medication works perfectly for one person but causes side effects or does not seem to work for another?   

A lot of times the answer lies in our genes. Traditionally, medications are prescribed at a standard dose for all patients based on average responses. While this standard dose may work well for most people, others may experience unwanted side effects or no benefit at all.   

Just as ‘one size does not fit all’ when it comes to clothing, the same is true for medications. Response to medication therapy is affected by several factors, including age, gender, other medications or illnesses, kidney and liver function, diet, exercise, patient’s overall health, etc. One of these factors is genetics.  Each person’s genetic makeup is unique, which means that the way medications work in our bodies can vary from person to person. In fact, several studies show 9 out of 10 people have a variation in their genes that may change how they respond to common medications. Due to these genetic differences, some people might experience great benefits from a medication, while others might not respond as well or might experience side effects from the same dose of medication.  

Pharmacogenomics (PGx), also called pharmacogenetics, testing is a genetic test used to understand how your unique genetic makeup can affect the way your body metabolizes certain medications. This field combines pharmacology (the science of drugs) and genomics (the study of genes and their functions) to personalize a treatment plan that is tailored to a person’s genetic makeup. The goal of pharmacogenomics is to find the right drug, at the right dose, for the right patient. 

Pharmacogenomics helps providers understand differences in patient’s genetic make-up and allows them to:   

• Reduce medication trial and error: By knowing how your genes affect drug metabolism, providers can select the medications and doses that are most likely to be effective.  
• Minimize risk of side effects: By identifying genetic variations that can cause adverse reactions, providers can choose medications that are safer for you. 

• Patients taking multiple medications, this is called polypharmacy 
• Patients have tried multiple medications that have not worked as expected
• Patients previously had, or are currently having a severe reaction or unexpected response to a medication 
• Patients starting on a new medication 

• Only certain medications have PGx implication, meaning that your genetic makeup can influence how well these drugs will work for you. PGx testing focuses only on medications with well-known risks and robust evidence and will not assess a patient’s risk for all medications that are currently prescribed in the U.S. nor dietary and herbal supplements. However, the field is rapidly evolving, and researchers are hopeful that PGx testing can be used for management of most common conditions in the near future.  

• It is important to understand that PGx testing is just another valuable tool and a piece of the clinical puzzle for your healthcare providers, that helps them make more informed decisions when prescribing medications. Other factors, such as your age, diet, lifestyle, liver and kidney function, and even other medications you may be taking, can also affect how drugs work in your body. By considering all these factors together, your healthcare providers will interpret the results and select the most appropriate medication for you.  

• The results of this test do not guarantee that a medication will certainly work for you and will not cause side effects at all. Also, if you have been stable on a medication for a while, you will most likely be continuing the medication even though your PGx test results may suggest otherwise. Interpreting results of PGx testing is complicated and should be done in collaboration with your provider and a trained pharmacist, when needed.  

Privacy of Genetic Information  

The Genetic Information Nondiscrimination Act (GINA), is a federal law that prohibits medical insurance companies and employers from discriminating against individuals based on their genetic information, including PGx test results. 

GINA does NOT offer protections in the following areas:  

• GINA does not apply to life, long-term care, or disability insurance 
• GINA's employment protections do not apply to employers with fewer than 15 employees  
• GINA’s protections in employment do not extend to the US military or employees of the federal government  

Learn more on the National Institutes of Health's Genetic Discrimination (Genetic Discrimination (genome.gov))