March 13, 2019: Sanford Health and the U.S. Department of Veterans Affairs announces a program that will provide pharmacogenetic testing to U.S. veterans at no cost to veterans or taxpayers.
By Katherine Capps, Co-Founder and Executive Director, GTMRx Institute
March 18, 2019
Last week, I had the opportunity to witness history—the announcement and video of the largest pharmacogenetic testing effort ever undertaken (check out highlights from the event—you might recognize someone around :50). This is the latest innovation effort from the Department of Veterans Affairs (VA)—an unsung trailblazer of health care innovations ranging from electronic medical records to team-based care models that utilize clinical pharmacists in collaborative practice. The test results will help with clinical decision making for a variety of pharmaceutical treatments and reduce adverse drug reactions, which cost $30 billion per year (according to NIH research) as well as the $528 billion a year wasted on non-optimized medication therapy.
The new PHASeR (Pharmacogenomics Action for Cancer Survivorship) initiative is a public-private partnership between the VA and Sanford Health, one of the largest health systems in the United States. Together they pledged to genetically test 250,000 veterans at 125 sites by 2022, all at no cost to the veterans. With a $25 million donation from philanthropist Denny Sanford and matching fundraising efforts and in-kind support by Sanford Health, they have the resources to make good on this commitment.
Understanding how each of us metabolizes various drugs through different pathways (fast, slow, normally, or not at all) is how pharmacogenomics can add critical insight for comprehensive medication management—the standard of care that ensures every patient’s medications are individually assessed to determine whether each is appropriate for the patient, effective for the medical condition, safe given the comorbidities and other medications being taken, and able to be taken by the patient as intended. The vision of the soon-to-be launched GTMRx Institute, which I co-founded and now serve as executive director, is to enhance life by ensuring appropriate and personalized use of medication and gene therapies. In short, we are bound by the urgent need to Get The Medications Right™. I’m proud to serve on the GTMRx board with Dr. Terry McInnis, Dr. Paul Grundy and former Undersecretary of Benefits for the Veterans Benefits Administration, Brigadier General Allison Hickey (retired). Having watched the VA closely when Allison served, I know that quality improvement has been a cornerstone of VA leadership.
VA Secretary Robert Wilkie lauded the partnership, saying relationships like this will continue to expand the department’s delivery of world-class health care. “The pharmacogenetic testing that we are going to be using as a result of Mr. Sanford’s generosity is critical for our VA physicians to prescribe the proper medications at optimized dosage based on the patient’s genetics, and the research will lead to dramatic breakthroughs.”
When announcing the initiative, the PHASeR program director, Dr. Deepak Voora of the Duke University School of Medicine, succinctly described the impact pharmacogenetic testing will have on physician decision-making.
“Currently, health care providers do the best they can to make sure that their patients get the best outcomes from the medications they prescribe with minimal side effects. As a physician, it is hard to predict exactly how my patient will respond to a medication that I prescribe. Pharmacogenetic testing has the potential to help providers make better decisions about medicines so they can prescribe the right dose of the right drug to the right patient.”
Sanford Health is leading the way in integrating patient genetic testing results with its primary care physician practices. Since Sanford Imagenetics began in 2014, more than 80 percent of patients tested have been found to carry a genetic change that could affect medication selection or dosing. Test results are shared with physicians through the electronic medical record to ensure efficiency and accuracy in choosing treatments.
In addition to the improvement in clinical decision-making for our veteran heroes, the PHASeR program will generate massive amounts of de-identified data to better understand how medications react to people with different genetics. I share the sentiments of Personalized Medicine Coalition President Edward Abrahams: “By investing in a program that is among the first to explore the clinical and economic value of personalized medicine on such a large scale, Sanford Health and the VA are leading the way toward a new era in health care that holds tremendous promise for patients and health systems.”
I join the personalized medicine health care community in applauding this effort. Sanford CEO Kelby Krabbenhoft said it best: “We wanted to put veterans at the front of the line when it comes to genetic medicine, genetic theories and genetic applications for health care…Using this info, doctors can prescribe the right medication the first time. After all, this is what our veterans deserve.”
With Secretary Wilkie, Sanford Health, and our veteran heroes on our side, clearly the GTMRx Institute is in good company.