New Orleans, Louisiana – Ochsner Health is leading the way for precision medicine nationwide by becoming one of the first hospital systems to standardize genomic testing, significantly advancing ways in which care teams can treat cancer patients. This change helps providers determine individualized treatment by understanding how patients will react to certain drugs, thereby lowering risk of adverse side effects, improving patient experience, and bettering patient outcomes.
Pharmacogenomics, or PGx, testing guides physicians how patients metabolize certain drugs and warns of possible side effects so they may adjust dosage in a way that provides individualized, personalized treatment. After a Louisiana law requiring insurance companies pay for the testing went into effect last year, Ochsner made it a required test for cancer patients receiving two types of chemotherapy drugs – 5-fluorouracil and capecitabine. The testing is now available at Ochsner's Baton Rouge and New Orleans regions and in Northern Louisiana locations. It will become a systemwide practice in coming months.
“We are leading the nation in this area,” said Marc Matrana, M.D., M.S., F.A.C.P., Ochsner Health’s System Medical Director for Precision Medicine and Endowed Professor of Experimental Therapeutics. “This is something unique Ochsner is at the forefront of, that is preventing hospitalization and saving lives. We’ve built this in a very thoughtful way, from advocating for new laws around reimbursement to integrating safety stops into the electronic medical record, that will serve as an example to the rest of the world.”
These tests are part of a pharmacogenomics program Ochsner launched in March 2022, available to all the health system’s patients. The service includes a comprehensive panel obtained through a standard blood test. It evaluates the function of nearly 30 genes and can provide useful information for about 200 medications. In addition to helping determine dosage of cancer treatment drugs, the test can help those who are prescribed blood thinners, have a history of adverse side effects to medications, require pain medications and who take medicine for a mental health condition, among others. It’s now used at Ochsner in a variety of specialties, including cardiology, psychiatry, cancer, rheumatology, pain management and infectious disease. Physicians and pharmacists can use the information to understand which medications and dosage regimens a patient is most likely to best respond. When applied in clinical practice, these pharmacogenomic results help patients because they can find which personalized therapeutics work for them more quickly and reduce potential treatment failures.
“These tests are innovative, but we are using peer-reviewed and evidence-based guidelines available for the drug/gene interactions for which we are testing,” said Catherine Oliver, PharmD, BCPS, DPLA, CPGx, System Director of Clinical Pharmacy Services for Ochsner Health. “Even if the patient doesn’t use the medications at the time of the test, it helps providers make decisions about individual care going forward.”
According to the Institute for Safe Medication Practices, barriers to widespread pharmacogenomic testing in clinical practice include the cost of testing, potential delays in patient care, potential lack of consensus dosing recommendations, and general lack of knowledge of recommendations by clinicians.
Through the work of local advocacy groups and cancer providers in Louisiana, insurance coverage for genomic testing is now required for patients with cancer diagnoses. Many of those patients have zero out-of-pocket costs associate with this testing, and for those who do incur out of pocket expenses, the costs are on average less than $100. Ochsner is one of the first hospital systems to have fully integrated this process into its electronic health records, placing pharmacogenomic information at providers’ fingertips so they can personalize care when needed.
Ochsner is also leading the way in PGx by covering the cost of testing under its three employee health plans for employees with certain mental health diagnoses. The one-time lab panel looks at a patient’s DNA to predict response to certain medications, including behavioral health therapies.
Ochsner’s testing partner, OneOme, is also working with other insurance plans to make testing as affordable as possible. All Medicare or Medicaid patients will have no out-of-pocket cost. While each patients’ commercial insurance plans vary, OneOme has a generous financial assistance program available to those who qualify.
Through the relationship with OneOme, Ochsner providers can have results in about five days, which prevents delays in care for cancer patients and others. Discrete results automatically flow back into the health record, making them useful for care teams. Pharmacogenomic testing is only needed once during a lifetime for most patients, and it is reflected in the patient’s record in a way that it is readily accessible now or in the future.
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About Ochsner Health
Ochsner Health is an integrated healthcare system with a mission to Serve, Heal, Lead, Educate and Innovate. Celebrating 80 years in 2022, it leads nationally in cancer care, cardiology, neurosciences, liver and kidney transplants and pediatrics, among other areas. Ochsner is consistently named both the top hospital and top children’s hospital in Louisiana by U.S. News & World Report. The not-for-profit organization is inspiring healthier lives and stronger communities. Its focus is on preventing diseases and providing patient-centered care that is accessible, affordable, convenient and effective. Ochsner Health pioneers new treatments, deploys emerging technologies and performs groundbreaking research, including 4,000 patients enrolled in 685 clinical studies in 2022. It has more than 38,000 employees and over 4,600 employed and affiliated physicians in over 90 medical specialties and subspecialties. It operates 48 hospitals and more than 370 health and urgent care centers across Louisiana, Mississippi, Alabama and the Gulf South; and its cutting-edge Connected Health digital medicine program is caring for patients beyond its walls. In 2022, Ochsner Health treated more than 1.4 million people from every state and 62 countries. As Louisiana’s top healthcare educator of physicians, Ochsner Health and its partners educate thousands of healthcare professionals annually. To learn more, visit https://www.ochsner.org/
Method of Research
Meta-analysis