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Use of Genomics is One Form of Personalized Medicine in the Department of Veterans Affairs

The Department of Veterans Affairs (VA) believes in seeing each patient as a unique individual deserving personalized medicine and medical care. From dietary counseling for patients with chronic diseases to cognitive behavioral therapy tailored to combat stress our warfighters experience, the VA’s long-standing interest in providing tailored solutions is a key treatment strategy within the healthcare system. In recent years, the VA has also embraced advancements in genomics to provide even more effective care and bespoke treatment options.

Veterans have different health needs than the general population, in part due to their military service experiences and service-related environmental exposures. To that end, the VA funds the integration of genetic information into clinical decisions as well as various genomics research to include identifying genetic markers associated with health conditions more frequently experienced by veterans. The expectation is that both can lead to earlier disease detection and interventions, better prognosis and patient outcomes, more effective treatments, and fewer side effects.

Cancer, in particular, is at the forefront of the VA genomics research efforts. The internal, large-scale VA Million Veteran Program (MVP) is a true cornerstone. Initiated in 2011 with approximately 875,000 veterans enrolled to date, the program collects DNA samples along with detailed health histories. This registry is then used by research to find connections about how our genes affect health.  

One groundbreaking study within the VA was the Precision Medicine in Mental Health (PRIME) Care in which pharmacogenomics (PGx) testing was implement for depression care. Research aimed to determine if genetic information could better predict a veteran’s response to the anti-depressant medications resulting in more effective treatments tailored to that individual. The size and scope of the patients highlights one key advantage of genomics within the VA as this study included over 1900 adult patients recruited from 22 sites across the nation.

Like all Federal Agencies, the VA funds research with the intention of using its findings to implement benefits for its population and the health system as a whole. While every genomics test available within the system is not available at every VA location to every patient at this time, the VA is always looking to improve its offerings – particularly when a little extra cost upfront can result in substantiated patient benefits, such as testing for Warfarin sensitivity to ensure veterans meet their therapeutic dose, or long term cost savings, such as with the Familial Hypercholesterolemia (FH) Screening to identify the genetic condition that increases the risk of heart disease and allows for earlier, less costly interventions.

The VA is well-positioned to be a leader in precision medicine adoption and implementation due to its large patient population and electronic health record system (EHR). Genomics promises to transform healthcare delivery by leveraging this technology and providing a more effective outcome for patients.


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