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Pharmacogenomics (PGx) in The Department of Veterans Affairs: A Commitment to Personalized Medicine

With a focus on how to best serve each patient where he or she is in their healthcare journey, the Department of Veterans Affairs (VA) healthcare system is at the forefront of personalized medicine. Pharmacogenomics (PGx) is one method with a meaningful role in fulfilling this endeavor.


Traditionally, medications are prescribed based on a standardized, "one-size-fits-most" approach. The approach to treatment is different when PGx test results from analyzing a patient’s DNA to identify gene variations are available to clinicians. The VA healthcare system offers its Pharmacogenomics Analysis for Safe and Effective Rx (PHASER) program to the veterans it serves. PHASER was launched in 2019 by the VA and Sanford Health's Imagenetics program. The program offers multi-gene pharmacogenomic (PGx) testing at approximately 50 sites, serving up to 250,000 veterans. The program provides pharmacogenetic testing at any VA facility for approximately 40 different medications.



Information gathered under PHASER is subsequently used to support clinicians when prescribing common medications including but not limited to mental health, pain, inflammatory disorders, and cardiovascular conditions. The PHASER blood test is free to patients and available by request through primary care providers. Results are then documented in the patient’s file and become an additional available resource for other clinicians during future medical encounters.


Patient benefits include:


  • Selection of medications with a higher likelihood of success.

  • Reduction in medication switching due to gene-based ineffectiveness or adverse reactions.

  • Personalize dosing to ensure a drug’s efficacy based on the understanding of an individual’s metabolism.

  • Achieving better health outcomes through better treatment response rates.


One example of the practical application of the PHASER genetic test results is specific to veterans suffering with chronic pain. Due to their time in service, veterans often suffer with pain and need more tools for chronic pain mangement. The management of that pain is both a serious and complex healthcare issue because it greatly influence’s an individual’s quality of life. PHASER is able to support veterans differently with their pain management. By understanding if a veteran is genetically pre-disposed to having a limited opioid response, alternative non-opioid medications can be prescribed.


Veterans often have complex medical histories and take multiple medications. PGx allows for more effective treatment strategies through its targeted approach. While a health care system is advantaged through resource optimization (such as reducing future doctor visits), the patient is greatly advantaged through improved symptom control as well as avoidance of potentially dangerous side effects. By tailoring health care treatments to an individual’s genes, the VA demonstrates its commitment to providing the best personalized healthcare possible.


PHASER Site Implementation


 

Here are some resources that lend additional perspective for manufacturers as they consider some of the benefits and spillover associated with PHASER partnerships:


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