Louisiana-based Ochsner Health is standardizing pharmacogenomics testing, which it says lowers risk of adverse side effects, improves patient experience, and better patient outcomes.
Pharmacogenomics, or PGx, testing guides physicians how patients metabolize certain drugs and warns of possible side effects so they may adjust dosage in a way that provides individualized, personalized treatment. Ochsner says it is one of the first hospital systems to have fully integrated this process into its electronic health records, placing pharmacogenomic information at providers’ fingertips so they can personalize care when needed.
After a Louisiana law requiring insurance companies pay for the testing went into effect last year, Ochsner made it a required test for cancer patients receiving two types of chemotherapy drugs – 5-fluorouracil and capecitabine. The testing is now available at Ochsner's Baton Rouge and New Orleans regions and in Northern Louisiana locations. It will become a systemwide practice in coming months.
“We are leading the nation in this area,” said Marc Matrana, M.D., M.S., Ochsner Health’s system medical director for precision medicine and endowed professor of experimental therapeutics, in a statement. “We’ve built this in a very thoughtful way, from advocating for new laws around reimbursement to integrating safety stops into the electronic medical record, that will serve as an example to the rest of the world.”
These tests are part of a pharmacogenomics program Ochsner launched in March 2022, available to all the health system’s patients. The service includes a comprehensive panel obtained through a standard blood test. It evaluates the function of nearly 30 genes and can provide useful information for about 200 medications. In addition to helping determine dosage of cancer treatment drugs, the test can help those who are prescribed blood thinners, have a history of adverse side effects to medications, require pain medications and who take medicine for a mental health condition, among others.
It’s now used at Ochsner in a variety of specialties, including cardiology, psychiatry, cancer, rheumatology, pain management and infectious disease. Physicians and pharmacists can use the information to understand which medications and dosage regimens a patient is most likely to best respond. When applied in clinical practice, these pharmacogenomic results help patients because they can find which personalized therapeutics work for them more quickly and reduce potential treatment failures.
“These tests are innovative, but we are using peer-reviewed and evidence-based guidelines available for the drug/gene interactions for which we are testing,” said Catherine Oliver, PharmD, system director of clinical pharmacy services for Ochsner Health, in a statement. “Even if the patient doesn’t use the medications at the time of the test, it helps providers make decisions about individual care going forward.”
Through the work of local advocacy groups and cancer providers in Louisiana, insurance coverage for genomic testing is now required for patients with cancer diagnoses. Many of those patients have zero out-of-pocket costs associate with this testing, and for those who do incur out- of-pocket expenses, the costs are on average less than $100.
Ochsner is also covering the cost of testing under its three employee health plans for employees with certain mental health diagnoses. The one-time lab panel looks at a patient’s DNA to predict response to certain medications, including behavioral health therapies.
Through the relationship with its testing partner, OneOme, Ochsner providers can have results in about five days, which prevents delays in care for cancer patients and others. Discrete results automatically flow back into the EHR, making them useful for care teams.
