Pharmacogenomics education, research and clinical implementation in the state of Minnesota

Jeffrey R. Bishop, R. Stephanie Huang, Jacob T. Brown, Pawel Mroz, Steven G. Johnson, Josiah D. Allen, Suzette J. Bielinski, Julie England, Joel F. Farley, David Gregornik, Jyothsna Giri, Christine Kroger, Susie E. Long, Tiana Luczak, Erin J. McGonagle, Sisi Ma, Eric T. Matey, Pinar K. Mandic, Ann M. Moyer, Wayne T. NicholsonNatasha Petry, Pamala A. Pawloski, Allyson Schlichte, Stephen W. Schondelmeyer, Randall D. Seifert, Marilyn K. Speedie, David Stenehjem, Robert J. Straka, Jason Wachtl, Stephen C. Waring, Brian Van Ness, Heather A. Zierhut, Constantin Aliferis, Susan M. Wolf, Catherine A. McCarty, Pamala A. Jacobson

Research output: Contribution to journalArticlepeer-review

Abstract

Several healthcare organizations across Minnesota have developed formal pharmacogenomic (PGx) clinical programs to increase drug safety and effectiveness. Healthcare professional and student education is strong and there are multiple opportunities in the state for learners to gain workforce skills and develop advanced competency in PGx. Implementation planning is occurring at several organizations and others have incorporated structured utilization of PGx into routine workflows. Laboratory-based and translational PGx research in Minnesota has driven important discoveries in several therapeutic areas. This article reviews the state of PGx activities in Minnesota including educational programs, research, national consortia involvement, technology, clinical implementation and utilization and reimbursement, and outlines the challenges and opportunities in equitable implementation of these advances.

Original languageEnglish (US)
Pages (from-to)681-691
Number of pages11
JournalPharmacogenomics
Volume22
Issue number11
DOIs
StatePublished - Jul 1 2021

Bibliographical note

Funding Information:
Preparation of this article was supported by the University of Minnesota’s Grand Challenges program through its support of the Minnesota Precision Medicine Collaborative’s Pharmacogenomics Project (Jacobson, Aliferis, McCarty, Wolf, principal investigators). JR Bishop has served as a consultant to OptumRx. P Mroz is supported by the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI), grant K12HS026379 and the National Institutes of Health’s National Center for Advancing Translational Sciences, grant KL2TR002492. Additional support was offered by the University of Minnesota Office of Academic Clinical Affairs and the Division of Health Policy and Management, University of Minnesota School of Public Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of AHRQ, PCORI or Minnesota Learning Health System Mentored Career Development Program. In the past 36 months, JD Allen has served as a consultant for the following companies: 23andMe, Clarigent Health, Inagene, Tempus Labs, Translational Software. JF Farley has received financial support for consulting provided to Takeda and receives grant support through the University of Minnesota for research funded by Astra Zeneca. J England is an employee of OneOme LLC. Mayo Clinic Laboratory provides pharmacogenetic testing. Mayo Clinic has stock ownership in and has licensed intellectual property to OneOme LLC. Mayo Clinic also receives royalties from Assurex Health. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

Funding Information:
The RIGHT10K project is an ongoing collaboration among Mayo Clinic, Baylor College of Medicine and OneOme in which 11,000 individuals have undergone sequencing-based testing for 84 pharmacogenes with entry of 12 of these into the EHR [33]. The study aims to determine the clinical implications of variants of uncertain significance identified through sequencing, whether pre-emptive PGx testing improves outcomes and reduces costs, and how clinician and patient perceptions of care are affected. eMERGE-PGx was a targeted sequencing study supported by NIH to assess variation in 82 pharmacogenes and to integrate information into the EHR [34]. Essentia Health and Mayo Clinic, along with others in the nation, enrolled ∼5000 participants. eMERGE-PGx identified a median of two actionable PGx variants per person, with more than 1800 individuals having three or more actionable variants. Extrapolating this to national prescription information suggested ∼75 million prescriptions in the USA could be affected each year by knowing genetic variation.

Funding Information:
Preparation of this article was supported by the University of Minnesota?s Grand Challenges program through its support of the Minnesota Precision Medicine Collaborative?s Pharmacogenomics Project (Jacobson, Aliferis,McCarty,Wolf, principal investigators). JR Bishop has served as a consultant to OptumRx. P Mroz is supported by the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI), grant K12HS026379 and the National Institutes of Health?s National Center for Advancing Translational Sciences, grant KL2TR002492. Additional support was offered by the University of Minnesota Office of Academic Clinical Affairs and the Division of Health Policy and Management, University of Minnesota School of Public Health.

Publisher Copyright:
© 2021 Future Medicine Ltd.. All rights reserved.

Keywords

  • Minnesota
  • implementation
  • pharmacogenomics

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