I am not located in Missouri, can I still receive services through GenePharmer, LLC?
The short answer is “possibly”. I am currently licensed to provide services to patients in Missouri and Vermont while acting as a pharmacist and/or a genetic counselor. I am also able to provide genetic counseling services (pending changes in legislation) in the following states: Alaska, Arizona, Colorado, Florida, Hawaii, Kansas, Maine, Minnesota, Mississippi, Montana, Nevada, New Jersey, New York, North Carolina, Rhode Island, South Carolina, Texas, West Virginia, Wisconsin and Wyoming. If I am unable to provide services where you are located, I will help you find a pharmacist or genetic counselor who can.
Why doesn’t GenePharmer, LLC bill insurance?
Currently, pharmacists and genetic counselors are often not recognized as “providers” by insurance companies unless billing in collaboration with a physician. There is also the problem of insurance reimbursement. Unfortunately, insurance often reimburses providers at such low rates that it incentivizes the provider to move as quickly as possible from one patient to the next. Medication therapies and genetic test results can be quite complex, so these are not visits that should be rushed and is the reason that both the initial and follow-up consultations are scheduled for an hour each.
Your services seem expensive, why is that?
As mentioned above, medication therapies and genetic test results are complex. The fees charged are to cover the initial and follow-up visits and the genetic testing charge. In addition, several hours are spent outside of the consultation reviewing the genetic results (the reports are often 25-50 pages long!) and carefully evaluating each patient on an individual basis to make the most appropriate recommendations. Sometimes this evaluation requires additional research of the literature, phone consultations with laboratory personnel or with other experts. Even though each consultation may last an hour or less, great care and time are being dedicated to each patient outside of the consultation to make this service as beneficial as possible. If you knew that the information gained from PGx testing could save you adverse side effects or therapy failures in the future, would you consider the cost worth the knowledge and the avoidance of issues?
Have you, Jeri, had PGx testing?
Yes. I had testing for more than 30 genes and while I do not take many medications, I found the information useful. For example, my genetics likely explain why I had zero response to diazepam (Valium) when I had to take it prior to a procedure. I also now know that if I were to need an anti-platelet medication to prevent clot formation, clopidogrel (Plavix) is expected to work for me. Therefore, I wouldn’t need a more expensive anti-platelet medication such as Brilinta. In addition, I learned that several common proton pump inhibitors (PPIs) such as omeprazole and pantoprazole may not work well for me, or I may need a higher-than-normal dose for the medication to be effective, but this also means I would have an increased risk for side effects from the medication. There are three common antidepressants, sertraline, citalopram, and escitalopram that I am expected to metabolize too fast to get any benefit from. Therefore, if I ever needed an antidepressant, these would not be the best choices. I learned a lot more than this about my genetics, but I think you get the idea of how I could use the knowledge gained from my test results. I absolutely believe in my mission of cultivating better health, one genome at a time.
Have you, Jeri, had NGx testing?
Yes. I had testing through 3X4 Genetics and it was incredibly insightful! My genetics information suggested a tendency for difficulty processing several micronutrients, including vitamins B9 (folate), B12, C and D. Blood testing for these vitamins confirmed such a deficiency and helped direct targeted supplementation. I was also found to have a variant in the DIO2 gene that can make it more difficult to convert T4 to T3. T3 is the active thyroid hormone. As someone with Hashimoto’s thyroid disease, this made me feel even better about taking desiccated thyroid replacement that contains both T3 and T4. The “standard of care” thyroid replacement medication is known as levothyroxine and it contains T4 only. For someone with potentially impaired conversion of T4 to T3, levothyroxine may not be the best choice.