For Providers

How can pharmacogenetic testing help inform medication response?

Often we use medications as a one-size-fits-all-approach, which may be successful for some patients but not for others. Personalized medicine is an innovative approach to tailoring medications that takes into account differences in people’s genes, other medications, and clinical factors. The goal of personalized medicine is to target the right treatments to the right patients at the right time.

Differences in genes that code for drug transporters or metabolizing enzymes can impact a body’s total exposure to a drug. Exposure is often related to effectiveness and toxicity – too little and the drug won’t work, too much and the drug causes side effects. In the same way a person with declining kidney function will build up levels of certain drugs, a person with a decreased-function drug metabolizing enzyme will build up levels of active drug.

Most people have at least 1 variant of a pharmacogene that might affect medication therapy throughout their life.^1-3 So far, there over 300 drugs with PGx information in their FDA label, including 11 with boxed warnings.

If your patient registers with MyRx on their own (without a provider-faxed referral), they will be prompted to provide us with your information so you can be sent their individualized consult (including pharmacogenetic test result interpretation and recommendations for current and future medications).

• If the patient does not inform MyRx of their provider’s information, the individualized consult will be provided directly to the patient in our secure patient portal.
• In this case, it is the patient’s responsibility to share the consult with their provider to aid with medication decisions and changes.

For UF Health providers

• Electronic referrals can be placed in Epic by ordering REF853, “Appt Req Pharmacogenetics”.

We will contact your patient upon receiving referral and order testing on your behalf once patient confirms they want to proceed.

• You may also directly order the pharmacogenetic test in Epic, LAB12305000 “Gator PGx”. We recommend ordering blood and send patient to a UF Health pathology lab draw station.

We will contact your patient upon result return to offer services.

What does MyRx provide?

MyRx conducts pre-test education, facilitates pharmacogenetic testing if needed, conducts post-test patient education, collects medication history, interprets results in context of current medications, and provides a personalized consult note for provider on how to adjust current and future medications.

Pricing information

MyRx Journey

Step 1. Refer your patient

• Fax referral to 352.627.4121
• Order in Epic: REF853 – appointment required pharmacogenetics

Step 2. Patient engagement

• MyRx provides your patient with:
  • Pretest education
  • Testing coordination
  • Medication history collection

Step 3. Pharmacogenetic testing

Order test in Epic: Lab12305000 – GatorPGx

The patient will complete one of the following:

• An at-home cheek swab
• A blood sample at a lab

Step 4. Pharmacist interpretation

The MyRx pharmacist will:

• Interpret pharmacogenetic results
• Review current medications
• Identity gene-drug interactions

Step 5. Personalized provider consult

Providers will receive a written report in Epic or a secure fax with the following:

• Pharmacogenetic interpretation
• Medication Guidance
• Recommendations for current and future therapy

Questions?

Call (352) 273.6415 or email myrx@cop.ufl.edu.

What genes do we test?

Our consultation service currently tests a panel of genes that affect commonly used medications to treat anxiety, depression, heartburn, pain, cholesterol, and cardiovascular indications, among others.

• ABCG2
• CYP2B6
• CYP2D6
• CYP2C19
• CYP2C9
• SLCO1B1
• VKORC1
• CYP2C cluster
• CYP4F2
• CYP3A5

• Clinical Pharmacogenomic Implementation Consortium
  Expert-reviewed guidelines for drug-gene pair implementation, standardized terminology and other resources.
• PharmGKB
  Searchable pharmacogenetic database that allows clinicians, students and researchers to search for pharmacogenetic information on drugs, genes, variants, regulatory resources and implementation resources.
• FDA Table of Pharmacogenetic Associations
  Table of pharmacogenetic associations that are related to drug metabolizing enzyme gene variants, drug transporter gene variants, and gene variants that have been related to a predisposition for certain adverse events.

Hear from providers who have used this service

“I have used genetic testing to create a treatment plan for my patients with depression and anxiety,” said Molly Posa, M.D., an associate professor of pediatrics in the UF College of Medicine. “I am grateful for the MyRx program, and the information it provides to help select the most effective medication for my patients. It’s an invaluable tool in my clinical evaluation and decision-making process.”

"As a family medicine physician, I care for patients across the lifespan who often present with complex medication histories and variable responses to treatment. Integrating pharmacogenetic testing through MyRx has been a valuable addition to my practice, providing clinically actionable information that supports more precise medication selection and dosing. The MyRx process is efficient, easy to implement, and well-received by patients. These insights have strengthened shared decision-making and increased confidence when initiating or adjusting treatment plans, particularly for patients with prior medication intolerance or treatment failure."

"As the Child Psychiatrist / Addictionologist in the Pediatric Behavior and Development Clinic, I frequently care for patients with suboptimal response to medications, having unexpected adverse effects, or failed trials to multiple psychotropic medications. It has been my pleasure to work with our MxRx team of pharmacogenetic experts, who promptly respond with individualized, comprehensive reports and clinically relevant recommendations based on the patient's pharmacogenetic profile and previous medication response. The MyRx process is easy to integrate into clinical practice. It has been an advantage to have the MyRx team within UF and our collaboration elevates the care we are able to provide."

"I cannot thank you enough for preparing this report. Your timing was perfect since I met with patient recently and was so beneficial in support of the medication adjustments that we have been doing. Her history is complex and the patient was very appreciative as well and left the appointment more confident in our treatment plan in regards to the medication changes. Again, thank you."

Email us if you would like a CME presentation on the use of pharmacogenetics in your own clinic!

References

¹Pharmacogenomics: The case for provider practice integration. GenoPATH.
²Scharfe CPI, et al. Genetic variation in human drug-related genes. Genome Med. 2017;9(1):117.
³Van Driest SL, et al. Clinically actionable genotypes among 10,000 patients with preemptive pharmacogenomic testing. Clin Pharmacol Ther. 2013;95(4):423-31.