Will Genetics Become the New Standard in Healthcare?

In this edition, Business Class talks with Dr Lior Rauchberger about genomics and the role of pharmacy in education and advice, and first‑step testing.

Business Class:

Lior, tell us a little bit about your background and professional training?

Dr. Lior Rauchberger:

I studied Medicine at Monash University followed by Entrepreneurship at Swinburne University. I have a passion for technology and worked as a technology integrator/
commentator for the past decade. Given my background, I am particularly interested in how technology and innovation is transforming medicine and healthcare delivery.

The advances in wearable technologies, mobile computing, the internet of things and bioinformatics will deliver exciting opportunities and challenges for healthcare professionals this decade.

The study and promise of genomics has captured my imagination over the past few years. As our knowledge of genomics continues to grow exponentially, genetics will become the new norm in healthcare.

BC:

What role do you see genomics playing and can you give some practical examples when it comes to medicine?

LR:

Genetic information is more accessible and affordable than ever before. This era of genomics is redefining the practice of medicine and there is a huge amount of research being conducted around the world in this space.

One of the most practical examples is in the field of personalized prescribing; using DNA results to predict how individuals metabolize certain medications. This exciting field, known as pharmacogenomics, can reduce side effects and improve treatment efficacy for our patients.

Personalized prescribing is only the ‘tip of the genomics iceberg’. Nutrition, exercise and lifestyle genomics is the next frontier of personalized healthcare and wellness. There are already companies in the US that are offering whole genomic sequencing for under US$1,000. Once this level of genetic data is available on a larger scale, the implications for personalized medicine and healthcare are endless.

BC:

What role do you see Pharmacy playing in this space?

LR:

Pharmacy plays an important role in educating consumers and other healthcare professionals about the increasing relevance of genomics in healthcare delivery. Further, DNA testing can routinely be performed by a quick and simple cheek swab in the pharmacy environment. Pharmacists can help identify which patients are likely to benefit from genetic test. For current pharmacogenomic testing this includes patients:

• experiencing side effects to specific medications;
• not responding to specific medications;
• requiring doses outside the recommended range; and
• planning to start new medications.

Offering a professional genetic test in a pharmacy has several benefits, including:

• a strengthened bond with local doctors;
• better patient outcomes with respect to prescribed medications;
• increased customer retention; and
• an enhanced professional services offering.

BC:

Some patients fear this big brother world of genomics. Are their fears about health funds leveraging this against the consumer warranted?

LR:

Genomics is a very broad and emerging field. It is important that ethical, privacy and security issues are addressed by genetic providers. There are perceived concerns about ‘big brother
genomics’ that will need to be raised and addressed over the next 5–10 years. I believe the trend for consumers to have control and ownership of their health data is very positive and will afford a level of protection in this regard.

BC:

Governments have trouble funding traditional PBS medicines. How will it go about funding these test that are linked to personalized medicines?

LR:

Recent economic modelling has shown that widespread adoption of pharmacogeomics in Australia would save the government up to twelve billion dollars over a five year period. This field has been the subject of a large amount of research over the past two decades and a robust evidence base now exists to support testing in a number of clinical scenarios.

There are already many genomic tests in the United States that are covered by public and private health insurers. With evidence demonstrating that personalized prescribing is reducing side effects and improving drug compliance, I am confident many of these tests will be subsidised in the near future.

BC:

You are launching a specific DNA test at APP. Tell us a little about it?

LR:

We are launching a multi-gene DNA test at APP called myDNA (www.mydna.life). The myDNA test is a pharmacogenomic test that provides healthcare professionals with an expert clinical report to assist them make more informed prescribing decisions. The myDNA reports are easy to understand, yet comprehensive and actionable. When suitable the report provides expert medication recommendations supported by detailed findings and scientific references.

Over the past few months, many doctors and pharmacists have reported that the myDNA results have had a profound impact on some of their patient’s lives. In fact, a pharmacy trial completed showed that two thirds of people who took the myDNA test had a significant finding that could affect current and future medications.

As seen in Business Class – Autumn 2016