Biography
Biography: Brahma D. Sharma
Abstract
Time is up for continuing to prescribe drugs by trial and error. Eliminate the guess work. Most drugs work when prescribed to a ‘right’ patient.On the other hand, a ‘right’ drug prescribed to a ‘wrong’ patient could be and often is deadly.
The dilemma is: how do you differentiate between ‘right’ and ‘wrong’ patient before prescribing a drug? Even siblings often metabolize drugs differently due to inherited mutations (variations) among genes in their livers. Pharmacogenetics (PGx) is here to guide you. PGx test involves a simple cheek swab, yet provides powerful clinically actionable data for the life of a patient. It predicts before a drug is prescribed, if it is a ‘right’ drug for the ‘right’ patient or it has a high risk of potentially creating Adverse Drug Reaction (ADR) due to a slow acting gene, representing a ‘wrong’ patient, and should be replaced by another therapeutically equivalent drug which is metabolized by another gene which is functioning normally in the patient’s liver. Unmetabolized drug starts accumulating in the body and can lead to ADR due to increased toxicity and side effects, in millions of patients in the US alone. In fact, ADR is now the 4th leading cause of death here, one patient dies every 4 minutes. Insurance companies including Medicare often pay for the test.
Who needs PGx test urgently
It’s too late to order the test during surgeries in ERs. You need to have patient’s PGx report through EMR, EHR or cloud to prescribe personalized medicine to control pain, bleeding etc. I recommend every newborn should have the PGx test to insure even first prescription the child will ever get be personalized to reduce potential of an ADR. The risk of ADR increases exponentially by the number of prescription the patient is on. Coumadin/Warfarin, a commonly prescribed blood thinner to control thrombosis is number one drug requiring ER visits among senior patients.
PGx reducing healthcare cost
University of Illinois Health’s Personalized Medicine Program saved $600K annually by reducing hospital readmissions when they used PGx test to guide dosing of only one drug, Coumadin/Warfarin.
FDA requiring PGx test
FDA along with EMA, PDMA and HCSC is recommending, in fact requiring a PGx test before prescribing 54 of the drugs carrying Black Box Warnings. Alas, healthcare professionals keep ignoring the requirement. I appeal to all healthcare professionals to be progressive and adopt PGx test and change their practices to personalized medicine.