The landscape of pharmacogenetic testing in a US managed care population
The landscape of pharmacogenetic testing in a US managed care population
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DOI：
10.1038/s41436-020-0788-3
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发表时间：
2020-04-15
影响因子：
8.8
通讯作者：
Aquilante, Christina L.
中科院分区：
文献类型：
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作者：
Anderson, Heather D.;Crooks, Kristy R.;Aquilante, Christina L.
目的对于有多少参保患者接受药物遗传学检测知之甚少。我们描述了美国管理护理人群中单基因药物遗传学检测的趋势，以及接受检测的患者的人口统计学和临床特征。方法：我们从付费医疗和药房索赔数据集中随机抽取近1100万患者样本，以确定至少有一项索赔表明接受了这些单基因药理学测试中的至少一项的患者：CYP2C19、CYP2D6、CYP2C9、VKORC1、UGT1A1和HLA 1类分型。结果2013年1月1日至2017年9月30日，5712例患者接受了至少一次药物遗传学检查（55%为女性，平均年龄为43岁）。每位患者检测次数中位数为3次（平均值= 2.7次，最大值= 12次）；54%通过管理医疗保险/医疗补助处理，45%通过商业保险处理。从2013年（n = 1955）到2015年（n = 4192），接受药物遗传学检测的总次数增加了一倍以上，然后在2016年略有下降（n = 3946）。最常见的检测是CYP2C19 (n = 4719)，“长期（当前）使用其他药物”是最常见的诊断。结论通过患者保险进行药物遗传学检测的比例较低，但从2013年到2016年增加了一倍以上。这项研究强调需要更好地了解药物遗传学测试的使用模式和保险范围。
Purpose Little is known about how many insured patients receive pharmacogenetic testing. We describe trends of single-gene pharmacogenetic testing in a US managed care population, and demographic and clinical characteristics of patients who received a test. Methods We leveraged a random sample of nearly 11 million patients from a data set of paid medical and pharmacy claims to identify patients with at least one claim indicating receipt of at least one of these single-gene pharmacogenetic tests: CYP2C19, CYP2D6, CYP2C9, VKORC1, UGT1A1, and HLA class 1 typing. Results From 1 January 2013 to 30 September 2017, 5712 patients received at least one pharmacogenetic test (55% female; mean age = 43 years). The median number of tests per patient was 3 (mean = 2.7, max = 12); 54% were processed through Managed Medicare/Medicaid, while 45% were processed through commercial insurance. The total number of pharmacogenetic tests received more than doubled from 2013 (n = 1955) to 2015 (n = 4192), then decreased slightly in 2016 (n = 3946). The most common test was CYP2C19 (n = 4719), and "long-term (current) use of other medications" was the most common diagnosis. Conclusion Pharmacogenetic testing through patients' insurance was low, but more than doubled from 2013 to 2016. This study highlights the need to better understand utilization patterns and insurance coverage for pharmacogenetic tests.