1. PGx Testing PHARMACOGENOMICS
MASS: Providing PRACTICE MANAGEMENT solutions and services to the healthcare industry

2. WHAT IS PHARMACOGENOMIC (PGx) TESTING?
Pharmacogenomic testing is the study of how a person’s genetic makeup
affects their response to medications.
In doing this, it aims to develop a strategy to optimize drug therapies.
Data with respect to a patient’s genotype is used to maximize drug efficacy while minimizing adverse drug effects and drug-drug interactions.

3. HOW IT WORKS……
Cytochrome P450 metabolizes 70-80% of the drugs being prescribed today.
DNA is gathered by the buccal swab
Genetic code + existing scientific material + databases = personalized results
Our testing focuses on the Cytochrome P450 family of enzymes.
The Cytochrome P450 enzymes primarily exist in the liver and help metabolize 70-80% of the drugs being prescribed today.
In the same way an individual’s genes influence their height and hair color,
their genes can also influence the types of Cytochrome P450 enzymes
that their body generates.
These traits are observable in the DNA that is gathered by the buccal swab used in our non-invasive Pharmacogenomic test, and may indicate the possibility of reduced pharmacological efficacy and even adverse drug related events.
By applying information derived from an individual’s genetic code to existing scientific material and databases, CQuentia Labs Pharmacogenomics Report is able to provide a physician with a personalized utility for each of their unique patients.

4. ADVERSE DRUG EVENTS ARE PREVENTABLE.
82% of American adults take at least one medication and 29% take five or more. (CDC).
Adverse Drug Events(ADE) cause over 700,000 emergency department visits each year. (CDC).
Nearly 120,000 patients each year need to be hospitalized for further treatment (CDC) .
Over 100,000 people die each year due to adverse drug events (FDA).
4th leading cause of death, Ahead of pulmonary disease, diabetes, AIDS, pneumonia, accidents and automobile deaths (FDA).
ADEs cause injuries or death in 1 of 5 hospital patients. (New England Journal of Medicine).
$3.5 billion is spent on extra medical costs dues to ADEs annually (CDC).
THE BENEFITS OF PGX ARE CLEAR
improved patient outcomes when initiating drug regimens
reduced risk of harmful drug-drug interactions
reduced risk of adverse drug events.
ADVERSE DRUG EVENTS ARE PREVENTABLE.
Let them read for a minute
Emphasis on the Benefits section

5. PGx TESTING CYCLE Physician agrees to test patients
Account set up form filled out completely, along with physician signature
Account Representative sets up training for the clinical staff responsible for the test
Kits are shipped to the clinic or the Account Rep
Patient is tested and kits are sent back Fedex two day
Accessioning takes place, and the testing begins if paperwork and everything is in order
If there is an issue during accessioning, the clinic and the Account Rep will be contacted
Testing begins and the results are ready in 3 to 5 business days
Physician results Portal and the Sales portal will be activated

6. Our PGx Testing Partner?
Tour website briefly

7. WHERE TO FIND INFORMATION / TOOLS
MASS Shared Dropbox Folder
Tour DropBox briefly – focus on Account Set Up folder, Insurance Folder, CQ Live Folder and Marketing Materials
The “rack cards” and Physician’s Brochures in the Marketing Folder are for electronic use only. Hard copy / printed materials should be requested from the Account Manager.

8. Account Setup Form Review form
Emphasis on importance of for portal
Emphasis on importance of location info matching what comes in on the test req forms.
Physician info and NPIs are required
Initial Kits always sent to rep
Physician signature required

9. Instructions for PGx Sample Collection
Review this document thoroughly – the testing process and the req form are the MOST important parts of what we do – if they are not correct the test cannot be done successfully.
Never use scissors
Always use clean gloves
Add initials and DOB to bar code
Req form in pouch NOT with samples

10. CQuentia Checklist Review quickly
The NOTE at the bottom pertains to nursing homes and facilities where the physician is not there on a regular basis.

11. Date / Time of Collection Source – Oral Buccal Swab
Attach demographic sheet
Don’t forget Ethnicity section
Cash pay – Patient and phone for PayPal Invoice– price quoted to the patient at the time based on Medicare current price and panels ordered.
Attach copy of insurance card – both sides
Medical Necessity – Mark as many as apply
Panel Order: Mark as many as apply – mark Comp and one other is applicable.
Current Medication List – attach print out if office has one – include OTCs if possible – must list specific medication patient is on or that the “doctor wants them tested for”
CYP2D6 and CYP2C19 – if a panel with these genes is marked – must have corresponding ICD10 Code on page 2.
"The intention of the lab requisition is not to say that a practitioner MUST mark
"a particular code from each section"... A patient's diagnosis is a patient's diagnosis. We never weigh in on that.
The purpose of the 2D6 and 2C19 ICD10 DX sections on the req form is to enumerate for the practitioner the DX codes that MEDICARE REQUIRES IN ORDER FOR THE 2D6/2C19 TESTS TO BE CONSIDERED MEDICALLY NECESSARY. If the diagnosis code is not appropriate for the patient, then no ICD9 from that section should be chosen.
Must have at least 1 General ICD10 code for ALL patients
MUST have Dr. signature and Patient Signature – cannot run test without both of these
Attach Bar code and sign bottom
2C19 / 2C9 / FII / FV / VKORC1 – clotting disorders / anti-coagulants – (clopidagrel)
2D6 / ABCB1 - anti-depressants and anti-psychotics
SLC01B1 – statins
MTHFR – folic acid
3A4 / 3A5 – opioids (codeine, acetaminophen, erythromycin etc.)

12. Review
Must have at least 1 marked in the general section (bottom right) – if 2D6 and / or 2C19 are marked on front must have codes to match
Codes are chosen by the Dr, NP, or PA for which they feel the patient qualifies

13. Genetic Response Report
This is the report generated in CQ Live in a printable format.

14. CQ Live
Great handout for marketing – it is in DropBox under CQ Live folder.

15. CQ Live CQ Live Demo http://livedemo.cquentialabs.com/
CQ Live Video v=YpQb1aIt_tY
Review the CQ Live demo thoroughly – unless they have already seen it and are familiar with it.

16. Questions?