GENEius RX is using Pharmacogenetics to Improve Medication Outcomes

When we first met Jamila Amirali, the founder and CEO for GENEius RX, we knew we had discovered a gem – a cutting-edge company with the same passion and drive we have when it comes to mental health and the over-prescription of medication.

At MB Group, we had long been observing a worrying trend in the group insurance stats. Employees are using little to none of their psychology coverage while the quantity of prescriptions for drugs used to treat mental illness steadily rises.

GENEius RX was noticing the same trend from the front lines of the pharmaceutical industry. Having practiced in pharmacy for nearly two decades, they had seen a significant increase in the use of medications to treat mental illness: particularly antidepressants across all age groups, but especially in the adolescent and young adult population.

What could be done?

Jamila described some of the main systemic issues causing this influx, namely that our healthcare system is strained; family doctors are extremely busy, specialists have longer and longer waitlists, and most retail pharmacies are focused on dispensing prescriptions.

“We are seeing the impact this has on patient care,” said Jamila. “It’s not uncommon to see five people all from the clinic next door come to the pharmacy with the exact same medication prescribed for depression. Based on textbook findings, it should work for all of them, right? Then why is it that at least one will return because they failed therapy?”

The truth is that the same dose of medication is not a catch-all solution for every person. “We are forgetting one very important factor,” said Jamila. “Medications are generic, and people are unique.”

This is the motto at GENEius RX where the focus is Pharmacogenetic (DNA) testing, or the science of using a patient’s own genetics to help in predicting their individual response to a medication.

Jamila explained how this works. “Our current prescribing model relies on trial and error to some extent,” Jamila said. “For example, if you’re diagnosed with depression or anxiety, a prescriber will likely initiate a medication and ask you to try it for two to four weeks. If you don’t tolerate it or don’t see improvement, then you go back to try something else, and the process repeats until you’re able to find a drug that works.”

This may sound okay on paper, but anyone who has experienced depression or anxiety knows that two to four weeks is an eternity. Having to repeat the process several times can have huge implications on an individual’s health and wellbeing.

“With Pharmacogenetics, we have shifted from this one-size-fits-all approach to a personalized one,” explained Jamila. “We categorize patients into different metabolizer groups, allowing prescribers to individualize medications and doses to optimize treatment outcomes for their patients.”

This is a crucial development, because the failure rate for antidepressant medications is high. Failure can mean two things: either a patient experiences adverse effects, or the medication is not effective in treating their symptoms. More than 50% of patients fail therapy with their first antidepressant trial.

Our genetics play an important role in metabolizing medication, which helps to explain why two people prescribed the same dose of medication have widely differing responses.

One example of medication with a high failure rate is the common SSRI Cipralex, which is used to treat depression and anxiety. Cipralex is metabolized by the protein coding gene CYP2C19. A huge percentage– around one third of individuals – have a genetic variant that makes them a rapid or ultra-rapid metabolizer, which means that the drug is cleared more rapidly from their system. They are unlikely to see any benefit with standard prescription recommendations. On the other hand, if an individual has a genetic variant that makes them a poor metabolizer, they are not able to clear the drug out of their system as efficiently and are at higher risk of experiencing adverse effects.

GENEius RX offers a proactive, rather than the current reactive, approach to prescribing. Jamila outlined the patients most likely to benefit, including people taking multiple medications, experiencing side effects, not responding to their medication, and those who are planning to start a new medication that may be impacted by genetic variants.

Interestingly, given the proactive nature of Pharmacogenetics, anyone interested in having this information can benefit from testing even if they are not currently taking medication.

If an individual knows their genetic variants ahead of time, it will help in personalizing medication regimens in the future, should they need it. This is the kind of knowledge that is deeply empowering for the individual. It also helps prescribers do their job more efficiently, at a lower cost to the healthcare system, and with more confidence.

The topic of over-prescribing mental illness is always a tough subject. Certainly, many mental illnesses can be addressed powerfully through psychological support currently going unused, as we can clearly see in group insurance. However, medication is often a necessary and life-changing treatment option, especially when paired with psychological support.

If medication is a positive option for our clients, patients, and loved ones, we would rather see less trial-and-error, less pain and adverse reactions, less reliance on standard prescription recommendations, and better, more effective health outcomes.

At MB Group, we’re excited to partner with GENEius RX in our joint efforts to create better outcomes in mental health.

Learn more about GENEius RX here.