Pharmacogenetics and Drug Development
Recently, some writers have been worried that the spread of pharmacogenetics may lead to higher healthcare costs due to the development of expensive new drugs. However, most of these fears are either unfounded or based on misunderstandings.
For most people, detecting drug-metabolism-affecting genetic variations will not mean that they need to wait for brand new drugs to be developed. The most common conditions already have many different drugs available on the market and most pharmacogenetic problems can be easily solved by encouraging the prescriber to reach for another, already existing drug. For example, if a patient is at risk of codeine-toxicity due to a CYP2D6 variation, morphine could easily be substituted for the codeine since morphine doesn’t go through the CYP2D6 pathway.
In this case, the system ends up saving money because pharmacogenetic testing can help prescribers avoid adverse drug events. It’s estimated that adverse drug reactions account for 20% of hospital readmissions and can cost US hospitals up to four billion dollars each year in direct costs.
Even with rare diseases, also known as orphan diseases, which may not have an array of available medications, pharmacogenetics may actually help drive down prices. As we've covered in a previous article, pharmacogenetic testing might help refine clinical trial design, and reduce drug development costs and help providers personalize treatment. Furthermore, compared to giving the patients ineffective medications new drugs, including targeted therapies, could be developed to improve patient care and reduce the number of unsuccessful treatments.
Fears of pharmacogenetics leading to increased drug costs are unfounded. These inexpensive diagnostic tests can help doctors avoid serious, potentially costly adverse drug effects and treatment failures, improve drug effectiveness and streamline drug development costs.