Recently, Jamie Wilkey, PharmD, RPh, CEO of Arches Health, LLC, contacted me. She trains PharmDs to leverage expertise in pharmacogenomics to consult in various areas of healthcare. We talked about how pharmacists can bring a wealth of knowledge, including pharmacogenomics, to work in a variety of roles in the pharmaceutical industry.
She kindly offered to write a guest post about how PharmDs who are trained in pharmacogenomics (PGx) are particularly well-suited for working in the pharmaceutical industry. Here is her guest post co-written by her colleague Jennifer Marquez, PharmD, BCOP, GPGx, Founder/CEO of PharmDNA, LLC.
Why having pharmacogenomics (PGx) expertise makes PharmDs invaluable for pharmaceutical companies
- PharmDs are trusted.
- PharmD roles are constantly expanding.
- PharmDs are the most knowledgeable about drug actions within the body.
- PharmDs are endorsed for the role.
- PharmDs are educated in PGx.
- PharmDs provide a solution to a proven roadblock to PGx implementation.
- PharmDs are ready to adequately employ their expertise to benefit patients.
Introduction
PharmDs are the ideal professionals to champion the implementation of precision medicine into our daily lives. Pharmacogenomics (PGx) is a specific path of precision medicine unique to a PharmD’s skill set.
The pharmaceutical industry relies heavily upon identified gene-drug-disease relationships in order to research, develop, and promote new therapies. Therefore, having PGx expertise increases a pharmacist’s marketability for pharmaceutical company careers. Pharmaceutical companies are helping to champion the implementation of PGx in clinical practice by researching and developing treatments in response to our ever-growing knowledge of gene-drug-disease relationships. Pharmacists with PGx expertise will be an invaluable part of drug research, development, and promotion for years to come.
PharmDs are trusted.
A 2018 Gallup poll has pharmacists placed as the third most trusted profession in terms of honesty and ethics. The profession has consistently placed among the top trusted professions for the last 20-plus years.1
PharmD roles are consistently expanding.
The history of pharmacy practice evolution in America since the 1920s has demonstrated a slow but steady improvement in professional standing through pharmacy education and practice. As more traditional compounding roles have waned, leaders within community pharmacy have sought to shift focus from product to patient. Increasing degree requirements and postgraduate training have enhanced pharmacists’ ability to provide patient care services not directly associated with medication dispensing.2 The wide variety of career paths that a pharmacist can take today are absolutely astounding!
PharmDs are the most knowledgeable about medications.
Since PGx analyzes how the genetic makeup of an individual affects their response to drugs,5 and pharmacists already possess the most knowledge of drug actions within the body, it is a natural fit for pharmacists to add PGx knowledge to their repertoire. PGx informs which combination of medication and dosage is most effective and safe for a particular patient,6 and is therefore simply one more piece of the puzzle to be considered.
Understanding genetic factors is of utmost importance in the treatment of many conditions. For example, many cancers are associated with genetic mutations. The presence of both somatic (tumor) and germline (inherited) mutations can give insight into whether certain treatments are likely to be effective, whether dosage adjustments should be made, or what alternative agents should be used instead. Certain mutations can even alert us to increased risk of drug-associated toxicity. Having expertise in this area makes you uniquely suited to discuss these factors intelligently with clinicians as a representative of the pharmaceutical company.
Precision medicine has allowed pharmaceutical companies to develop new treatments with such genetic knowledge. Knowing which mutations are associated with disease allows for the research and development of targeted therapies. Many currently-available drugs already have requirements for companion diagnostic tests. Performing the companion diagnostic test is not only required for payor reimbursement of many drugs, but having the results allows for personalization of patient drug therapies, optimizing their outcomes.
PharmDs are endorsed for the role.
The American Society of Health-System Pharmacists (ASHP) issued an official statement in 2021 on the Pharmacist’s Role in Clinical Pharmacogenomics. In it, they state, “Because of their distinct knowledge, skills, and abilities, pharmacists are uniquely positioned to lead interprofessional efforts to develop processes for ordering pharmacogenomic tests and for reporting and interpreting test results. PharmDs are also singularly and uniquely qualified to lead efforts to guide optimal drug therapy selection and drug dosing and provide patient as well as provider education based on those results. PharmDs therefore have a fundamental responsibility to ensure that pharmacogenomic testing is performed when needed and the results are utilized to optimize medication therapy.”7
PharmDs are educated on PGx principles.
As of 2007, many pharmacy schools have incorporated principles of PGx into their curricula, and the amount of training provided typically surpasses that received by their counterparts in medical school.8 Given the significant advancements in PGx over the past decade, the 2019-2020 American Association of Colleges of Pharmacy Pharmacogenomics Special Interest Group updated the pharmacist competencies. The process used a systematic approach which included mapping PGx-specific competencies to the Entrustable Professional Activities for pharmacists and seeking consensus from key stakeholders. The final result is an expansion to 30 competencies that reflect the contemporary roles pharmacists play in the application of PGx in clinical practice. When implemented into curricula, these competencies will ensure that learners are “practice-ready” to integrate PGx into patient care.9 Not surprisingly, doing so has led to significant improvements in pharmacists’ level of aptitude and confidence in dealing with pharmacogenomics in clinical practice.10
PharmDs who did not receive PGx training while in pharmacy school also have a variety of options for gaining knowledge and expertise in the area. Several reputable companies offer courses to obtain PGx certification. Popular courses are offered by PGX101, ACCP, ASHP, and Mayo Clinic, among others.
PharmDs provide a solution to a proven roadblock to PGx implementation.
Despite the increased interest in genetics in the public sphere, the rate of adoption of PGx testing in the clinical setting has been uneven. There is a significant gap in genomic literacy among medical doctors and other healthcare professionals. Indeed, only 10% of doctors responding to a USA-based survey reported feeling confident in their knowledge of PGx and its clinical application, less than 30% of those ever having ordered a PGx test, and only ~10% of those had recommended or ordered a test in the previous six months.11 This data highlights the need for PGx experts to fill this gap. PharmDs are the PGx experts that healthcare providers need to close the gap of translating this knowledge into actionable, evidence-based recommendations that optimize real-life patient drug therapy outcomes.
PharmDs are ready to adequately employ their expertise to benefit patients.
PharmDs are the drug experts and they are ready to use their knowledge in more meaningful and fulfilling ways. PGx is one way that many of them are choosing to use their skills.
The world will be changed by implementation of PGx into clinical practice. PharmDs will be the ones leading the way, and patients will reap the benefits. Pharmaceutical companies are doing their part to bring targeted therapy options to the market for patients who need them. PharmDs with PGx expertise will be an invaluable part of drug research, development, and promotion by pharmaceutical companies for years to come.
REFERENCES
1. Gallup, Dec. 3-12, 2018 (obtained from news.gallup.com)
2. Towards a Greater Professional Standing: Evolution of Pharmacy Practice and Education, 1920-2020. Pharmacy 2019, 7, 98: doi:10.3390/pharmacy7030098 (obtained from www.mdpi.com/journal/pharmacy)
3. A comparison of medical and pharmacy students’ knowledge and skills of pharmacology and pharmacotherapy. Br J Clin Pharmacol 2014; 78:4, 781-788.
4. Bissell L. Why and how pharmacists should get involved in medical education. Clin Pharm 2012;4:301.
5. Ermak G (2015). Emerging Medical Technologies. World Scientific. ISBN 978-981-4675-80-2
6. GTMRx Institute. Action changes things. https://gtmr.org/learning-center
7. 2021 ASHP Statement on the Pharmacist’s Role in Clinical Pharmacogenomics
8. Pharmacogenomics education in medical and pharmacy schools: conclusions of a global survey. Pharmacogenomics. Volume 20, Issue 9, June 2019. Pages 643-657.
9. Pharmacists Leading the Way to Precision Medicine: Updates to the Core Pharmacist Competencies in Genomics. Am J Pharm Educ 2021 Jul 22;8634.
10. Transitioning Pharmacogenomics into the Clinical Setting: Training Future Pharmacists. Frontiers in Pharmacology. August 2016, Volume 7, Article 241.11. Pharmacogenomic Testing: Clinical Evidence and Implementation Challenges. J Pers Med 2019, 9, 40.
Authors
Dr. Jamie Wilkey, PharmD, RPh
Founder, PGx Consulting Confidence Academy
CEO, Arches Health, LLC
Email: jamie@archeshealthgroup.com
Website: PGx Consulting Confidence
Dr. Jennifer Marquez, PharmD, BCOP, CPGx
Founder/CEO of PharmDNA, LLC