Purpose

The increased availability of clinical pharmacogenetic (PGx) guidelines and decreasing costs for genetic testing have slowly led to increased utilization of PGx testing in clinical practice. Pre-emptive PGx testing, where testing is performed in advance of drug prescribing, is one means to ensure results are available at the time of prescribing decisions. However, the most efficient and effective methods to clinically implement this strategy remain unclear.

Methods

In this report, we compare and contrast implementation strategies for pre-emptive PGx testing by 15 early-adopter institutions. We surveyed these groups, collecting data on testing approaches, team composition, and workflow dynamics, in addition to estimated third-party reimbursement rates.

Results

We found that while pre-emptive PGx testing models varied across sites, institutions shared several commonalities, including methods to identify patients eligible for testing, involvement of a precision medicine clinical team in program leadership, and the implementation of pharmacogenes with Clinical Pharmacogenetics Implementation Consortium guidelines available. Finally, while reimbursement rate data were difficult to obtain, the data available suggested that reimbursement rates for pre-emptive PGx testing remain low.

Conclusion

These findings should inform the establishment of future implementation efforts at institutions considering a pre-emptive PGx testing program.

中文翻译：

---

先发制人药物遗传学检测临床实施策略的多站点调查

目的

临床药物遗传学 (PGx) 指南的可用性增加和基因检测成本的降低慢慢地导致了 PGx 检测在临床实践中的使用增加。先发制人的 PGx 测试，即在开药前进行测试，是确保在开药决定时可获得结果的一种手段。然而，临床上实施该策略的最有效和最有效的方法仍不清楚。

方法

在本报告中，我们比较和对比了 15 家早期采用机构的先发制人 PGx 测试的实施策略。我们对这些群体进行了调查，收集了有关测试方法、团队组成和工作流程动态的数据，以及估计的第三方报销率。

结果

我们发现，虽然先发制人的 PGx 测试模型因站点而异，但机构有几个共同点，包括识别符合测试条件的患者的方法、精准医学临床团队参与项目领导，以及根据临床药物遗传学实施联盟指南实施药物基因可用的。最后，虽然报销率数据难以获得，但现有数据表明，先发制人 PGx 检测的报销率仍然很低。

结论

这些发现应为考虑先发制人的 PGx 测试计划的机构制定未来的实施工作提供信息。