TY - JOUR

T1 - Primary Care Prescription Drug Use and Related Actionable Drug-Gene Interactions in the Danish Population

AU - Lunenburg, Carin Adriana Theodora Catharina

AU - Hauser, Alexander Sebastian

AU - Ishtiak-Ahmed, Kazi

AU - Gasse, Christiane

PY - 2020

Y1 - 2020

N2 - Pharmacogenetics (PGx) aims to improve drug therapy using the individual patients’ genetic make-up. Little is known about the potential impact of PGx on the population level, possibly hindering implementation of PGx in clinical care. Therefore, we investigated how many patients use actionable PGx drugs, have actionable genotypes or phenotypes and which patients could benefit the most of PGx testing. We included PGx recommendations from two international PGx consortia (Clinical Pharmacogenetics Implementation Consortium (CPIC) and Dutch Pharmacogenetics Working Group (DPWG)). Using data from publically accessible sales information drawn from the Danish Register of Medicinal Product Statistics (MEDSTAT), we identified the number of users of actionable prescription PGx drugs among the total Danish population in 2017. We estimated actionable genotypes or phenotypes based on reported frequencies from literature. We identified 49 drug-gene interactions related to 41 unique prescription drugs. The estimated median frequency of actionable genotypes or phenotypes among prescription drug users was 25% (interquartile range 7–26%). Six of 41 drugs were used more than twice as much in women. Actionable PGx drugs were most frequently used by 45–79 year old patients (62%), followed by 25–44 year old patients (18%). Almost half of the actionable PGx drugs (19/41) were psychotropics (i.e., antidepressants, antipsychotics, or psychostimulants). PGx testing can have a substantial impact on the population, as one in four prescription drug users has an actionable genotype or phenotype and could thus benefit from PGx testing. We advocate for prospective panel-based PGx testing at the time of the first PGx drug prescription (“as needed”), with PGx results ready prior to start of the first, and all future, therapies.

AB - Pharmacogenetics (PGx) aims to improve drug therapy using the individual patients’ genetic make-up. Little is known about the potential impact of PGx on the population level, possibly hindering implementation of PGx in clinical care. Therefore, we investigated how many patients use actionable PGx drugs, have actionable genotypes or phenotypes and which patients could benefit the most of PGx testing. We included PGx recommendations from two international PGx consortia (Clinical Pharmacogenetics Implementation Consortium (CPIC) and Dutch Pharmacogenetics Working Group (DPWG)). Using data from publically accessible sales information drawn from the Danish Register of Medicinal Product Statistics (MEDSTAT), we identified the number of users of actionable prescription PGx drugs among the total Danish population in 2017. We estimated actionable genotypes or phenotypes based on reported frequencies from literature. We identified 49 drug-gene interactions related to 41 unique prescription drugs. The estimated median frequency of actionable genotypes or phenotypes among prescription drug users was 25% (interquartile range 7–26%). Six of 41 drugs were used more than twice as much in women. Actionable PGx drugs were most frequently used by 45–79 year old patients (62%), followed by 25–44 year old patients (18%). Almost half of the actionable PGx drugs (19/41) were psychotropics (i.e., antidepressants, antipsychotics, or psychostimulants). PGx testing can have a substantial impact on the population, as one in four prescription drug users has an actionable genotype or phenotype and could thus benefit from PGx testing. We advocate for prospective panel-based PGx testing at the time of the first PGx drug prescription (“as needed”), with PGx results ready prior to start of the first, and all future, therapies.

U2 - 10.1111/cts.12768

DO - 10.1111/cts.12768

M3 - Journal article

C2 - 32166845

AN - SCOPUS:85082414178

VL - 13

SP - 798

EP - 806

JO - Clinical and Translational Science (Print)

JF - Clinical and Translational Science (Print)

SN - 1752-8054

IS - 4

ER -