Oncology Genetic Testing: Pharmacists’ Knowledge Gap

July 2012, Vol 3, No 5 - AMCP Annual Meeting

San Francisco, CA—Knowledge of pharmacogenomics—the genomic factors contributing to individual variability in response to drug therapy (or personalized medicine)—enhances the ability to diagnose, prevent, and treat disease, especially a variety of cancers. The correct application of pharmacogenomics to patient management is essential for providing cost-effective care, but many providers, includ – ing physicians and pharmacists, are lacking appropriate knowledge of the science. Other barriers include lack of transparency in clinical utility and in appropriate reimbursement strategies.

At the 2012 Academy of Managed Care Pharmacy annual meeting, Angela Luong, PharmD, and colleagues at OPTUMInsight described the results of their survey of pharmacists regarding their knowledge of genetic testing and utilization strategies.

A total of 19 pharmacists at 4 different managed care organizations responded to the survey; their responses revealed a basic lack of knowledge of pharmacogenomics. The majority (84%) of respondents agreed or strongly agreed that pharmacogenomics will have an impact on healthcare expenditures and pharmacists should have a good knowledge base of related drug therapies and tests; however, they admitted they did not have much education in this area. Overall, 95% of participants scored <60% on a pharmacogenomics test.

In addition, knowledge of pharmacogenomics does not appear to immediately have a direct impact on patient care or benefit design. Only 47% of respondents said their plan requires prior authorization (PA) for the use of the US Food and Drug Administration–approved companion diagnostic test for vemurafenib compared with 58% of respondents whose plans require a PA for the companion test for crizotinib.

By contrast, only 16% of respondents said their plans require testing for HER2 mutation before prescribing trastuzumab compared with 58% of respondents whose plans do not require testing and 26% (n = 5) who did not know whether their plans require such testing.

Furthermore, the majority of respondents did not know whether their plans had reimbursement policies related to pharmacogenomics. Overall, this survey reveals gaps in pharmacists’ knowledge of personalized medicine utility and its relation to benefit design strategies.