Doctors at The Vancouver Clinic will soon have the ability to consider patients’ genetic information when prescribing medication and determining whether to begin early cancer screenings.
The Vancouver Clinic is teaming up with ActX, a Seattle-based genomic screening company, to offer patients testing that providers can use to personalize medicine based on the patient’s genetic profile. The clinic began offering the service last month.
“There’s been a lot of talk about precision medicine,” said Dr. Marcia Sparling, medical director of informatics and specialties at The Vancouver Clinic. “That’s what this is.”
The screening is optional and comes with a price tag of $395. The Vancouver Clinic is offering a discounted price of $335 through the end of June. The test is not covered by insurance.
Patients who elect to undergo the screening will receive a kit in the mail and will return a saliva sample, which ActX will check for 600,000 genetic markers. The results are sent to the physician and patient and are also integrated into The Vancouver Clinic’s electronic health record.
“We met the people that developed the program and thought it was such a sensible way to take genetics and really incorporate it into medical care,” Sparling said. “It isn’t a complex 20-page report that gets filed away and forgotten. It’s in the medical record and in a way physicians can understand.”
Identifying potential problems
One of the key functions of the screening program is to identify potential problems with prescription drugs. Medication effectiveness is based on large patient populations, but about 90 percent of people carry genetic variations that would affect medications, either making them ineffective or causing undesirable side effects, said Dr. Andrew Ury, ActX CEO.
With the screening program, when a physician writes a prescription for a patient, an alert will pop up if the patient’s genetics reveal a potential problem with that medication. The doctor can then adjust the dosage or prescribe a different medication, Ury said.
“To be able to avoid giving people a medication that won’t be effective is good, I think, for the system and the patient,” he said.
It also reduces the trial-and-error piece of medicine, Ury said.
“All of us have had patients who’ve had trouble tolerating medications, and it’s hard to know what to do,” Sparling said.
Preventive screening
Typically, if one medication doesn’t work or causes undesirable side effects, the physician has to try another similar medication and wait to see if it works better, she said.
“There isn’t really a fact-based way to decide,” Sparling said.
The testing can also identify hereditary conditions that could require monitoring or early preventive screenings. For example, the screening can identify if a person has Lynch syndrome, which puts them at risk for colon cancer at a young age. With that information, physicians can begin colonoscopy screenings when the patient is 25 or 30 years old, rather than the standard recommendation of 50 years old, Sparling said.
The screening can also identify if a person carries a gene that could cause serious medical conditions in their children, such as cystic fibrosis, she said.
“I really love the idea of being able to screen people for genetic risk before they even think about getting pregnant,” Sparling said.
The information provided by the genomic screening can be beneficial for any patient, Sparling said. While those who take multiple medications may see a benefit sooner, everyone takes medications at some point and could benefit from the information uncovered through genomic screening, she said.
Eventually, Sparling and Ury suspect genomic testing in early adulthood will be routine. We’re just not there yet, Ury said.
“There’s no question that The Vancouver Clinic is being innovative in adopting this technology,” he said.
