- Desjardins Assurances
The importance of pharmacogenetics in your group insurance plan
This article was written in consultation with Nathalie Rivest, BPharm, MSc, Product Director, Drug Insurance with Desjardins Insurance.
You’ve probably heard all about how DNA tests can sketch out your family tree using nothing more than a saliva sample. But did you know that medicine is pushing the science even further? Modern medicine can identify relationships between your DNA and the drugs available to treat certain illnesses. That’s what pharmacogenetics is all about. The field itself dates all the way back to the 1950s1, but it wasn’t until relatively recently that the public has had access to genetic testing, and it’s becoming more popular by the day.
But what’s so interesting about these tests? What can they tell us?
What is pharmacogenetics?
At first, pharmacogenetics might seem a little murky, but basically, it boils down to the study of how genetic variations (or mutations) can affect a drug’s efficacy. The impacts can be good or bad and can even affect the dosage required2.
We’ve all got an idea about what genetics is. For example, a long-lost uncle might see you and say, “You’re the spitting image of your mom!” Well, that’s genetics for you. Or a doctor might ask about your family history of a given disease. What you tell them might help them put their finger on the right illness, based on your genetic predisposition to it. If the drug you’re taking to treat your symptoms isn’t working, or is causing unpleasant side effects, they’ll change the dosage or try another drug and wait and see what happens.
They might also take a shortcut and recommend pharmacogenetic testing to try and identify the drug that would work best. This approach is often referred to as personalized medicine.
According to Nathalie Rivest, "While it’s not a magic bullet, being able to identify a drug that’s more compatible with a person’s DNA can help increase the likelihood that a treatment will succeed.”
The benefits of pharmacogenetics in the workplace
When a colleague is off work for an indefinite period, it affects the workload of everyone around them. The impacts are real: uncertainty, increased workload, sidelined projects, generalized stress. Disability management specialists do everything they can to help employees recover and get back to work under the best possible conditions. If it makes sense, they may suggest pharmacogenetic testing—an accessible, non-intrusive solution.
Why do pharmacogenetic testing?
Pharmacogenetic tests study the genes of the patient that could influence their response to a drug. This can help identify whether the available drugs are compatible with the sick person.
How does it work?
It all depends on genetic matching! Basically, you read the DNA sequencing of saliva cells, measuring hundreds of small variations in different areas of the molecule3. This information is used to search for compatible drugs so the most compatible (or the least incompatible) drug can be prescribed.
Is it accurate?
Since the results are based on available DNA data, the more tests that are done, the bigger the pool of gene sequences available for comparison. Your DNA is being compared to that of total strangers, but strangers whose genetic profile is similar to yours, who have taken the same drugs to treat the same symptoms, and who reacted in a particular way to the treatment.
You have to be careful! Making adjustments to drugs or dosage based on a person’s genetic profile doesn’t guarantee that the treatment will work. What it does do is bypass the trial-and-error method, which can drag on for months and cause the patient problems without relieving their symptoms.
An ally for mental health
This type of testing is increasingly used to treat numerous physical and mental health issues when the first prescribed drug isn’t the most effective, often because of a genetic incompatibility. The trial-and-error period can really take a toll on the patient. The side effects, the lack of improvement, the need to keep trying out new drugs… all of this can undermine their already fragile morale. Having access to more effective treatments from day one limits the unpleasantness of the trial-and-error period and can even speed up the recovery period, both of which can help the employee, their teammates and the employer.
Mental health disorders account for nearly 30% of short- and long-term disability claims across the country. They’re also one of the three main reasons for claims, according to 80% of employers in all activity sectors4.
The most common tests can be used to help people with:
- Attention deficit disorder with or without hyperactivity (ADHD)
- Cardiovascular disease
- Chronic pain
As Nathalie mentioned, pharmacogenetic testing can help increase the likelihood that a treatment will succeed. It makes it easier, and sometimes faster, for the patient to get back on their feet. When pharmacogenetic testing is integrated into a comprehensive disability management offer, the tests are an accessible and affordable way for plan members to sustainably return to active life.
1 C. Masse and P. Vandel, Contribution of pharmacogenetics, 2016.
2 Simon De Denus, Pharmacist and Researcher at the Université de Montréal, specialized in pharmacogenetics.
3 Simon Gravel, Assistant Professor of Human Genetics, McGill University.
4 Mental Health Commission of Canada, Making the Case for Investing in Mental Health in Canada.