Personalizing treatments for antidepressants and antipsychotics

Personalizing treatments for antidepressants and antipsychotics
Anh Nguyen, PharmD, Walgreens / Bethesda Family Medicine Clinic 

In 2017, 17.3 million adults in the United States reported at least one major depressive episode, making it the leading cause of disability. Resistant depression, not only is a burden to patients and their families, but also is a financial strain to the healthcare system.

UnitedHealthcare recently announced a new coverage policy for multi-gene panel testing for antipsychotic and antidepressant medications that became available starting October 1st, 2019. This new policy includes coverage for use of pharmacogenetic multi-gene panels to guide clinical decisions on medication if the individual has a diagnosis of major depressive disorder or anxiety, has failed at least one prior medication to treat their condition and multi-gene panel has no more than 15 relevant genes.

UnitedHealthcare’s new policy was guided by evidence from the GUIDED study published by the Journal of Psychiatric Research. This randomized controlled trial included more than 1,100 participants with depression who either received treatment guided by GeneSight, a pharmacogenomics test, or by conventional treatment methods without GeneSight guidance. Participants in the GeneSight group rate of admission at eight weeks were 50% higher than those in the conventional treatment group. Additionally, individuals in the Genesight group had a 30% higher rate of response and 11% greater improvement in symptoms. Other studies have demonstrated that using GeneSight saves $6,050 per patient in the first-year of healthcare costs and reduces disability claims and medical absence days.

UnitedHealthcare’s new coverage policy would not only benefit their customers but also the healthcare system itself. Personalized medicine would help patients achieve remission quicker, potentially reducing hospitalization rates, healthcare cost and risk of patient relapse. 

Reference:

  1. Clinical OMICs.UnitedHealthcare to cover genetic testing for precision medicine in depression anxiety.https://www.clinicalomics.com/topics/molecular-dx-topic/unitedhealthcare-to-cover-genetic-testing-for-precision-medicine-in-depression-anxiety/. Published August 2nd, 2019. Accessed November 14, 2019.