TIP-002 - EVALUATION OF A PHARMACIST-LED PHARMACOGENETICS CONSULTATION SERVICE ON HEALTHCARE COSTS AND OUTCOMES.

I. Fofanova¹, M. Norris², N. Mohan¹, A. Ong¹, K. Sassaman¹, C. Tocci¹, Z. Ye¹, J. Gums³, E. Cicali²; ¹University of Florida, Gainesville, FL, USA, ²University of Florida, Gainesville, FL, United States, ³Department of Pharmacy Education and Practice, College of Pharmacy, University of Florida, Gainesville, FL, United States.

Background: MyRx is a Pharmacogenetics (PGx) Consult Service offering patients a virtual educational visit with a PGx-specialized pharmacist. Medication history, Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) are collected prior to the visit. Following the visit, personalized medication recommendations are sent to the patient’s provider(s). While evidence exists supporting the clinical utility of pharmacogenetic testing on psychiatry outcomes, medication use, and overall cost, the additional benefit of pharmacist personalized consultation has yet to be evaluated.

Methods: Patients seen by MyRx are eligible for this study (283 seen to date, 80 pending). Medication history, GAD-7, and PHQ-9 are patient surveys collected as part of standard of care to guide medication recommendations. Survey invitations are sent to patients via REDCap. Manual chart review will be done to collect medication data at 0, 3, 6, and 12-months post consultation with data entered in REDCap. A patient survey will be sent to patients with anxiety/depression within 3 months following their consult to obtain follow-up GAD-7/PHQ-9 patient reported outcomes. Acceptance of medication recommendations will be evaluated by comparing number of inappropriate gene-drug pairs (i.e., inconsistent with guideline recommendations) prescribed at baseline with follow-up time points. A paired t-test will analyze changes in depression/anxiety scores from baseline to follow-up, and changes in number of PGx inappropriate gene-drug pairs. Overall cost savings will be evaluated by comparing 12 months pre- and post- consultation. Costs will be estimated for 1) medication cost and 2) health system costs. Medication cost will be calculated based on GoodRx pricing for a one-month supply multiplied by months a patient was on medication. Health system cost will be estimated by obtaining total reported cost of patient encounters (i.e., doctor visits, ER visits, and hospitalizations) in the given timeframe. A probit model and generalized linear model with gamma distribution will compare changes in medication and overall health system cost.

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Design: Genetic variations affect medication response, but uptake into clinical practice is limited. Pharmacist interpretation may improve outcomes and reduce healthcare cost, which will broaden PGx utility.