Forum Thread

Medicaid/Medicare May Cover Genetic Testing For Mental Health

• JFoster

  07-17-2018 03:16:00 PM

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  I guess I missed this in the news. I thought it was interesting to bring to the forefront. When I hear the words mental health and drug industry in the same sentence, I tend to cringe a bit. Mostly I do because what we as American citizens do know is how little the medical community and the drug industry do not know about mental health. This is why I provided two sources for this thread. One is the "butter-side-up" perspective, and the other is sort of the "butter-side-down" perspective.

  Mainstream genetic testing has only recently scratched the surface of popularity. I myself had mine done a few years ago. Not only will these tests tell you if you're actually Native American or not, but some provide medical information, essentially what health issues you may be susceptible to. While that information may be good, we are only receiving the tip of the iceberg at best. What I have found sounds promising for future application in the medical world. Perhaps doctors will use genetic testing in the future to help with the diagnosis of a patient.

  I came across an article from Genesight. Their argument is that genetic testing has shown improvement in the medication selection process for patients suffering from depression. Such as they claim that patients were 50% more likely to achieve remission and 30% more likely to respond to treatment when their medication was guided by their "Genesight Psychotropic" test. Now, I agree the article is self serving, and I found another article that pulls the facts out, as well as the stretched truth. They seem to think that the percentages are a bit off, especially because the data wasn't a result of a gold standard controlled test.

  But what we do know, and one of the main points of this thread is that the testing is covered by both Medicare and Medicaid. What this indicates to me is the possible future of coverage going forward. Perhaps once they work more bugs out of genetic testing, it will become more of a standard practice not only for mental health but everything else in the world of medicine. So what do you think? Is it all just smoke and mirrors? Or, is it a possible perk for the future?
• J.K.Logic

  07-17-2018 05:53:42 PM

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  Seems a solid attempt to make prescribing anti-depressants into more of a science. So that's a good thing, as right now I feel like doctors are just throwing pills at people and hoping it works out. As that article points out, most first time anti-depressant prescriptions fail to really help. So the patient has to go about pharma treatment on a trial and error basis, which could take several months to a few years, if it's even ever successful to any meaningful degree whatsoever.

  The downside to adding this to a doctor's arsenal is just like the article points out:

  Does the story adequately explain/quantify the harms of the intervention?

  Not Satisfactory

  Although harms from a cheek swab are unlikely there is a potential harm in framing the genetic testing results as guiding the choice of one antidepressant over another. Patients may focus solely on pharmaceutical options, to the exclusion of non-pharmaceutical ones.

  Antidepressants have well-documented side effects and drug interactions.

  
  That's an important point. Even if this does help a doctor narrow down which pharmaceutical to prescribe, it assumes an anti-depressant is the answer, and that it's just a matter of picking the right one based on the person's genetic markers.

  Perhaps if this tech is coupled with doctors being taught, in depth, about genetic markers and how that info can be interpreted into a holistic treatment plan for a person, this could really help.

  But that's a stretch, both to educate everyone involved AND to assume doctors and these companies don't just want to use this to validate the practice of what I believe most understand: to overprescribe anti-depressants in the first place.