A CASE FOR AFRO-INCLUSIVE pharmacogenomics precision medicine AUTHOR Stewart Masimirembwa
PEER REVIEWER: Buddy Modi
EXECUTIVE SUMMARY Adverse drug reactions (ADRs) are the unintended negative reactions to a drug. Some ADRs may result in hospital admissions, prolongation of hospital stay, injury or death, leading to economic and clinical costs. Payers and funders can incur extra costs as high as twice the initial cost of the healthcare services. More than thirty-five percent (35.4%) of major ADRs are caused by the interaction between a patient’s gene(s) with one or more drug(s). Not only do African populations have unique and different gene sets (genetic diversity), they also collectively have gene sets that are different from those of Causations and Orientals (genetic variability). This is problematic for African populations because most drugs, especially those for non-communicable diseases, are optimised for Caucasian populations. African populations experience ADRs with some drugs that work very well for Caucasians. Furthermore, a drug may work very well in some African populations, while causing ADRs in others. This problem suggests the need to use a person’s genes to determine how he/she will respond to a drug. Pharmacogenomics precision medicine, known simply as Pharmacogenomics or PGx, uses information about a person's genetic makeup to choose the drugs and drug doses that may work best for that particular person, thereby minimising the possibility or severity of ADRs. This article advocates for the mainstreaming of clinical pre-emptive pharmacogenomics and making it standard of care. Making patients’ genetic information available in their medical record will render 25% of PGx-guided treatment cost effective and 50% cost saving.
ADRS Medicinal drugs are chemicals or compounds used to cure, halt or prevent disease, ease symptoms, and help in the diagnosis of illnesses. Most commonly, these intended benefits are realised. However, patients often experience ADRs ranging from minor side effects to death. ‘Any deviation from the intended beneficial effect of a medication results in a drug-related problem (DRP),’ (Classen et al, 1991). In response to an initial drug therapy, a patient may develop one or more DRPs.
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