Alternative Therapies and the Role of Pharmacy
Genomic Medicine on the Rise
Healthcare trends and treatments live in a constant state of flux. History underscores that we are ever progressing in the ways we treat disease. It is easy to see the correlation between technological advances and medical interventions. They tend to go hand in hand. And as for pharmacy, the days of “one-pill-fits-all” or pharmacy as “only a dispensing agent” is out the door in history’s archives. Pharmacy is flying into the future with its own wings of smart technology and superiorly advanced pharmacology to work along side medicine. Today, the healthcare ecosystem is at the brink of being able to treat patients as never seen before. The traditional track of a physician’s subjective findings of a patient, ranging from blood panels to clinical exams to MRIs and PETs to a vast number of other diagnostic tools, now brings us to have a detailed look inside the DNA, which is known as genomic medicine. And where medicine goes, so goes pharmacy. With the advent of Genomic Medicine come alternative therapies that affect the pharmacist’s role and the workflow of pharmacy.
A little background
What is Genomic Medicine, briefly? Each person’s genome is made up of a unique sequence of DNA that contains the instructions for their growth and development. Differences in our DNA determine our unique characteristics and can also tell us what disease states may arise. Having a patient’s genetic map and genome sequencing where the order of their DNA is deciphered, which is made up of over 3 billion genetic letters, is surely the definition of cracking the code. The code to what though? Variations in a person’s genome can affect their individual response to a drug, and genome sequencing can help match patients to the most appropriate drug, calculate the best dose and predict whether they are likely to suffer adverse effects—a field called pharmacogenomics. Here is where the light dawns that genomics has started to drive pharmacy, and this further embarks upon the area of specialty pharmacy.
Trail-blazing science spurs trail-blazing pharmacy
Science has been trail-blazing a path to some of the most revolutionary alternative therapy of all time—gene therapy. Within gene therapy are multiple therapies to treat various disease states, therefore personalizing treatment. For example, let’s look at a few. Mapping a person’s genome is to know their blueprint of life. In the blueprint are answers to things the field of medicine once saw as mystery. Gene editing, a new frontier, is another example. The word edit brings to mind a document you might be editing and in that process you may use the cut and paste options. And that is exactly the process of gene editing. It’s one thing to cut and paste lines of text and a mind-blowing idea to be able to be able to edit a gene inside a body, like a cut-and-paste operation. Stem Cell therapy is another alternative where blood or bone marrow samples can be obtained and harvested with antibodies to help patients fight their diseases. We have arrived at a juncture to truly individualize a patient’s treatment plan. Personalized medicine is here. Imagine, flowing in our blood are the keys to health, and together science and pharmacy can unlock the doors of disease.
Is pharmacogenomics the white knight of drug therapy?
Pharmacogenomics is the relationship between DNA and how the body responds to drugs: how they’re absorbed and metabolized, and transported and eliminated from the body. The history of pharmacogenomics stretches as far back as 510 B.C. when Pythagoras noted that ingestion of fava beans resulted in a potentially fatal reaction in some, but not all, individuals. Is pharmacogenomics the white knight of drug therapy? Will the genome revolution drastically decrease the uncertainty in medicine? What will it be like in the future to have a database filled with what drugs will be effective and which ones should be avoided based on a person’s genome? Truth be told…the genome-based treatment era is already here and gaining momentum. Get ready.
The role of the pharmacist and the pharmacy
To date, the Food and Drug Administration (FDA) has approved over 100 drugs that encompass genomic details in their prescribing information. Genetics and genomics have been the subject of voluminous medical research. Genomic testing is becoming more accessible, which means moving it from the research arena into retail pharmacies. A pharmacist or a licensed practitioner will take a blood sample. The DNA will be dissected in a laboratory, and the results will yield what predispositions to certain diseases the patient has in his/her genome. At this point, the constellation of a patient’s blueprint can be shared among the healthcare ecosystem, an awareness never before experienced. Taking it further, if necessary, the doctor can prescribe medications to prevent or delay disease progression. In short, pharmacists will be able to compound and prescribe according to the genome results and collaboration with the healthcare team. Currently, there are a few pharmacies that have been doing DNA testing and analysis, taking blood samples to analyze patients’ genomes, and therefore, compounding the drugs to prevent or delay the disease states.
Precision medicine has great potential to prevent adverse reactions and wasted medications, and it may find its way into a new revenue stream for pharmacist due to the multiple branches genomics may create. There will be a greater need for further patient advocacy in the face of insurance companies. Insurance will be a marked consideration with this layer of medicine. Who gets the DNA testing and who doesn’t? Which providers are contracted and which ones aren’t, including pharmacy? Much will be required to keep track of these insurance details, not to mention the tracking requirements that will be required once a genome is determined. Patient education will become more enmeshed regarding the results of the genome and the compounding efforts to maintain that patient’s optimal health. Counseling in regards to the DNA procedure and the results yielded are another avenue to be paved. For example, the hereditary nature of the results upon other family members alone could create a domino effect, stretching the role of pharmacy into areas never before triggered. Inside all of this, of course, will be additional training for pharmacists as to the procedures and protocols for genomic testing and intervention. Each pharmacy will have to follow suit to be able to meet the demands of alternative therapies. Pharmacists will be, and some already are, on the frontlines of this revolution.
The roles of the pharmacist are ever multiplying, and in the case of Genomic Medicine, even more so.
Outcomes are on the pharmacist’s mind as part of every new intake and dispensing plan. Data and outcomes are part of the tapestry of the life of pharmacy. Genomics has the potential to markedly improve patient outcomes through the appropriate stratification of medications and pharmacists will be required to participate, bringing their expertise to the table. This field is wide open and there is much to consider as the pharmacy’s community in the ecosystem widens. Great responsibility rests upon pharmacy’s shoulders to mine the value in these alternative therapies. In conclusion, the market is focused heavily on specialty pharmacy, but specialty is no longer its own segment. Specialty pharmacy is now across all segments of pharmacy, changing the layout and design of how pharmacy does its day-to-day business and its preventative and healing business.
KeyCentrix has been walking with the future of pharmacy for decades. Working with the strands of technology and pharmacy, we have weaved a bridge for pharmacies to integrate alternative therapies into their existing structure. NewLeafRx is a forerunner that is here now with its vast capabilities to be configured to meet alternative therapies in the area of Genomic Medicine and beyond. Using NewLeafRx user defined fields, expansive data collection properties, and business rules, we can satisfy the technology required to support the clinical side of genetic therapy or genomic therapy. NewleafRx is built to know. We are excited to meet you in the future that we call now. Keeping pharmacy thinking is KeyCentrix’s goal at every turn in the healthcare ecosystem. While not every thing has a clear-cut answer, NewLeafRx has the capabilities and intelligence to lead pharmacy through what seems to be the “wild west” making the new frontier less daunting. To learn more and set up a demonstration visit www.keycentrix.com.
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