Genetic testing greatly benefits patients with depression, saving millions

A special kind of genetic test that helps determine the best antidepressant for patients with moderate-to-severe depression could generate substantive health system savings and greatly improve patient outcomes, according to new research from the University of British Columbia.

The study, published today in CMAJ, shows that in B.C. alone, implementing pharmacogenomic testing could save the provincial public health system an estimated $956 million over 20 years.

One in 10 Canadians will experience major depression at some point in their lives, making it one of the largest public health burdens. While more than 35 antidepressant medications are available in Canada, over half of patients don’t respond to the antidepressant they are initially prescribed and roughly 27 per cent report adverse effects.

For the study, the researchers worked with patient partners, clinicians and health system and government partners to develop a simulation model that mimics the experience of patients with major depression, from diagnosis through to treatment, recurrence and recovery. By incorporating B.C. health administrative data, clinical trial data and defined treatment strategies, the model compared the projected journey of 194,149 adults with and without pharmacogenomic testing over a 20-year period.

The model showed that pharmacogenomic testing would result in 37 per cent fewer patients experiencing treatment-resistant depression, a situation in which the patients’ depression does not improve despite trying several kinds of treatment. Pharmacogenomic testing would also result in patients spending 15 per cent more time without depression symptoms, resulting in an anticipated 1,869 fewer deaths and 21,346 fewer hospital admissions over 20 years.

Reference: Genetic testing could greatly benefit patients with depression, save health system million; Canadian Medical Association Journal; DOI:10.1503/cmaj.221785.