Objective:

We compared economic outcomes when elderly patients with neuropsychiatric disorders received psychotropic medications guided by a combinatorial pharmacogenomic (PGx) test.

Methods:

This is a subanalysis of a 1-year prospective assessment of medication cost for patients with neuropsychiatric disorders receiving combinatorial PGx testing. Pharmacy claims were used to compare per member per year (PMPY) medication cost for patients ≥65 and <65 years old when medications were congruent or incongruent with the PGx test. Polypharmacy was also assessed.

Results:

Congruent prescribing was associated with savings of US$3497 PMPY (P < .001) for patients ≥65 years and US$2467 PMPY (P < .001) for patients <65, compared to incongruent prescribing. Congruent prescribing in patients ≥65 treated by primary care providers was associated with US$4113 PMPY (P = .026) in savings, while congruent prescribing by psychiatrists was associated with US$120 PMPY (P = .719). Congruent prescribing was also associated with one fewer neuropsychiatric medication for patients ≥65 (P = .070).

Conclusion:

Congruence with PGx testing was associated with medication cost savings in elderly patients.

中文翻译：

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老年精神病患者进行组合药物基因组学测试后的经济结果

目的：

我们比较了老年神经精神疾病患者在组合药物基因组学（PGx）测试指导下接受精神药物治疗的经济结果。

方法：

这是对接受组合PGx测试的神经精神疾病患者进行为期1年的药物成本前瞻性评估的子分析。当药物与PGx测试一致或不一致时，使用药房索赔来比较≥65岁和<65岁患者的每人每年（PMPY）药物费用。还评估了多药店。

结果：

全等处方与美国的储蓄$ 3497 PMPY相关（P ≥65岁和US $ 2467 PMPY（<.001）的患者P <0.001）的患者<65，比不一致的处方。由初级保健提供者治疗的≥65岁患者的一致开处方可节省4113美元的PMPY（P = .026 ），而精神科医生的一致开处方可以节省120美元的PMPY（P = .719）。对于65岁以上的患者，一致开处方还可以少用一种神经精神科药物（P = .070）。

结论：

PGx测试的一致性与老年患者的药物成本节省相关。