The Use of Genetics in Guiding Therapy
Published: June 2012
Hot Topic Q&A is an opportunity for viewers to submit questions to the Hot Topic presenter. The opportunity to submit questions for this topic is now closed.
The following questions were submitted by viewers and answered by the presenter, Linnea M. Baudhuin, PhD, an Assistant Professor of Laboratory Medicine and Pathology, as well as a consultant in the Divisions of Clinical Biochemistry and Clinical Core Laboratory Services with a joint appointment in Medical Genetics at Mayo Clinic.
Questions are presented as submitted (unedited).
Which pharmacogenomic tests are likely to be covered by Medicare and other third party payors?
Unfortunately, there is not a good answer for this since it is determined locally. The provider would have to talk to the local Medicare carrier/third party reimburser since it varies by carrier/reimburser.
I did not see sertaline as one of the SSRIs. Is there a pharmacogenomic assay for this commonly prescribed drug?
Sertraline is metabolized by CYP2B6, CYP2C19, CYP2C9 and CYP3A4. It is a fairly safe drug to use since it is unlikely that all of these enzymes are impaired in a given patient. However, one could check CYP2C19, CYP2C9 and maybe CYP3A4 (although CYP3A4 was not released for this indication and therefore would be research).