The Smart Pharmacogenetic Card for personalized pharmacological treatment
There exists a large proportion of the population that does not respond, responds only partially or experiences adverse pharmacological reactions to the standard dose of a drug. Due to this, and faced with the lack of pharmacogenetic personalization of conventional treatments, healthcare expenditure is increased by 30%.
Nowadays, the administration of drugs is performed on a mass scale, so the same drug at the same dose is used for all patients with the same pathology.
This situation may be valid for a large part of the population; those patients whose response to the drug is most similar to the average values of the population.
Adverse reactions and toxicity of pharmacological treatment
However, it may also be highly detrimental, on the one hand to patients prone to presenting adverse reactions caused by the toxicity of the pharmacological treatment; or on the other, in whom the drug is ineffective during the treatment, entailing a need for high doses which would be toxic to the patient.
Between 40% and 80% of the degree of safety and efficacy of a drug depends on the pharmacogenetic profile of each patient.
The adverse reactions can even cause the death of the patient, and generate high costs, both on a healthcare level (hospitalizations) and on the level of the pharmaceutical companies (withdrawal of the drug from the market).
In fact, over 30% of acute admissions of elderly persons to American and European hospitals are due to iatrogenically-induced therapeutic complications; that is, due to unsuitable medication. The individual genetic profile explains, to a great extent, this great diversity in the response to drugs.
Genetic variability in the response to drugs
Health professionals strive to practice a personalized medicine, consisting of prescribing the right drug at the right dose to the right patient. This may be achieved by using Pharmacogenetics, which takes into account the interindividual genetic variability in the response to drugs, and thus the best treatment for each patient can be selected and the adverse effects minimized. Pharmacogenetics studies the genetic basis related to the proteins (enzymes) responsible for the transport and metabolism of the drugs, and also for the linking of a drug with its target.
Each individual possesses a series of variations in the code of these genes, which confers an interindividual variability in the capacity of these enzymes to carry out their functions, and this causes each person to have a personalized profile of tolerance to certain drugs, according to their pharmacogenetic profile.
Efficacy of pharmacogenetics in the prescription of drugs
The EuroEspes Pharmacogenetic Card bears the patient’s pharmacogenetic profile, so that both patient and physician may know the type of treatment that may be used and those drugs that should be avoided or whose dose should be adjusted.
Most international pharmacoeconomic studies, performed to assess the cost-efficacy relationship of medicines in prevalent pathologies (cardiovascular disease, cancer, nervous system disorders, hypertension, diabetes, hypercholesterolemia, dementia) stress that 10%-20% of the direct costs of these pathologies are of a pharmaceutical nature. Accepting this fact, and bearing in mind that the lack of pharmacogenetic personalization in conventional treatments increases expenditure by 30%, it may be inferred that the implementation of pharmacogenetic protocols in the treatment of chronic pathologies, particularly in long-term disabled patients, would enable a reduction in direct and indirect pharmaceutical costs of between 25% and 40%, depending on the primary diagnosis, concomitant diseases, the progression of the disease(s), polypharmacy, secondary intervention to mitigate adverse effects, and the patient’s pharmacogenetic profile.
In this way, we will progress considerably in the definition and practice of personalized medicine, placing at the disposal of physicians, patients and society in general the latest biotechnological tools which are affordable and easy to use and to interpret by physicians devoted to improving the treatment of their patients.
The implementation of pharmacogenetics in everyday practice entails a reduction in possible adverse reactions to drugs, a saving in pharmaceutical costs due to avoiding unsuited, ineffective treatments, and ultimately, greater relief for the physician and a better quality of life for the patient.