Join Ashlee as she talks with Ina, the Director of Clinical Operations at RxGenomix, about the fascinating world of pharmacogenomics. Throughout this episode, Ashlee and Ina get into the nitty-gritty of pharmacogenomic testing - a game-changer in ensuring the right medication is administered to the right patient at the right time and dose.
Listen to this episode to equip yourself with the knowledge to grasp the potential and significance of pharmacogenomics in patient care. Whether a healthcare professional or simply curious, it's time to step into the future of personalized medicine.
In this episode, the two discuss:
- Pharmacogenomics & their implications
- The role genetics play in influencing medication responses
- Integrating pharmacogenomics into routine patient care
- The future of pharmacogenomics
Dr. Ina Liko received her Doctor of Pharmacy degree at the University of Illinois at Chicago where she was initially exposed to pharmacogenomics. She then completed a clinical residency program at Monroe Clinic where her research project was focused on the implementation of pharmacogenomics. After this initial exposure to the clinical application of pharmacogenomics, she gained experience in implementing it in a larger scale by completing a fellowship in the Clinical Implementation of Pharmacogenomics at the University of Colorado where she was exposed to a systematic approach of implementing pharmacogenomics in various therapeutic classes. Dr. Liko now serves as the Director of Clinical Pharmacogenomics Operations at RxGenomix where she works collaboratively in a multidisciplinary team leading the clinical operations.
To learn more about CEimpact's By Design memberships, click here.
To learn more about the CEimpact Advanced PGx training, click here
Join Ashlee as she talks with Ina, the Director of Clinical Operations at RxGenomix, about the fascinating world of pharmacogenomics. Throughout this episode, Ashlee and Ina get into the nitty-gritty of pharmacogenomic testing - a game-changer in ensuring the right medication is administered to the right patient at the right time and dose.
Listen to this episode to equip yourself with the knowledge to grasp the potential and significance of pharmacogenomics in patient care. Whether a healthcare professional or simply curious, it's time to step into the future of personalized medicine.
In this episode, the two discuss:
- Pharmacogenomics & their implications
- The role genetics play in influencing medication responses
- Integrating pharmacogenomics into routine patient care
- The future of pharmacogenomics
Dr. Ina Liko received her Doctor of Pharmacy degree at the University of Illinois at Chicago where she was initially exposed to pharmacogenomics. She then completed a clinical residency program at Monroe Clinic where her research project was focused on the implementation of pharmacogenomics. After this initial exposure to the clinical application of pharmacogenomics, she gained experience in implementing it in a larger scale by completing a fellowship in the Clinical Implementation of Pharmacogenomics at the University of Colorado where she was exposed to a systematic approach of implementing pharmacogenomics in various therapeutic classes. Dr. Liko now serves as the Director of Clinical Pharmacogenomics Operations at RxGenomix where she works collaboratively in a multidisciplinary team leading the clinical operations.
To learn more about CEimpact's By Design memberships, click here.
To learn more about the CEimpact Advanced PGx training, click here
Ina, welcome. To Level Up, I'm really excited to get to meet you and I have the opportunity to spend some time with you. Do you mind just sharing a little bit about yourself and your role at ARX Genomics?
Speaker 2:Sure, thanks so much for having me. I'm excited to talk about pharmacogenomics today and I've really been in love with pharmacogenomics since I learned about it in school. I did a little bit of research in school with a couple of different drugs, mainly focused on cardiology in pharmacist school, and right after that I did a residency at a hospital where my main project was on how to implement pharmacogenomics in a setting and mainly implemented that in the mental health arena there. I thought, you know, wanted to learn a little bit more about implementing and how to do that on a bigger scale. So right after that I went to University of Colorado and completed a fellowship there on a pharmacogenomic implementation.
Speaker 2:After I graduated my fellowship, I learned about a lot of different processes and how to implement in a larger scale, but also got experience with having patient consultations as well as provider consultations and a few research projects. So I came to our genomics in actually in 2021, so I've been here for a few years now and my role here as the director of the clinical pharmacogenomic operations it's mainly it's very multidisciplinary. I do see patients on regular basis and do consultations with them when it comes to pharmacogenomics, talk to their providers, but then also communicate with our team, from marketing to IT to sales, as well, as I love educating people and just getting you know the same page about pharmacogenomics with other healthcare professionals, so I also host a webinar that we used to have every week, but now it's monthly about pharmacogenomic clinical pearls.
Speaker 1:Okay, this is amazing. So just for some background, for our listeners, cempact has partnered with RX Genomics and we have an advanced training. It's kind of like a primer to get to know what pharmacogenomics really is. Pharmacogenetics is really is actually. That's a great question, the difference between pharmacogenetics and pharmacogenomics. There's difference, right.
Speaker 2:Yeah, it's well because.
Speaker 1:I realized I use those words simultaneously, but then when I was saying it, there must be a difference. So, yes, we have an advanced training. That's a sidebar. We have an advanced training that we have put together over the past several years, but this month we are doing a refresh and so that is why we have brought Ena in to share a little bit more deeper insight as to what exactly her role is and what exactly the advanced training looks like. It's gonna be a primer of what this education is focused on and the rollout.
Speaker 1:We get a lot of inquiries from our listeners and from our newsletter subscribers as to what are other opportunities that pharmacists can advance their training, advance their expertise, advance their patient care, especially in the community. So we have collaborated with our genomics exact meds on how to educate pharmacists in this arena. So Ina is an expert, obviously, with her background. She has extensive training in pharmacogenetics and with her role at RxGenomics, we partnered with her to help support this and put together this advanced training. So just your background is so stellar and thank you for sharing with us.
Speaker 1:But as we're going to dive a little bit deeper into more of what exactly is pharmacogenetics, do you mind sharing with us. I guess the first question is the difference between well, first of all, what is pharmacogenetics? I mean, I was in pharmacy school 10 plus years ago now, so I have an idea, and I think I was fortunate because I went to a pharmacy school that had science bench work in this industry, in this realm. But I'm sure not. This was not talking to you. This is not an area that all pharmacy schools are focusing on. So do you mind sharing us a little bit about what is pharmacogenetics and then the difference between pharmacogenetics and pharmacogenetics?
Speaker 2:Yeah sure, so pharmacogenomics are how we call it, a PGX for short right.
Speaker 1:It's a big word.
Speaker 2:But in a nutshell, it's really looking at how your genetics can affect medication response. So we're all a little different in our DNA. I mean, we see the differences on the outside. We all look different, even within your family. You see differences in siblings and even your parents. So because of that, of course, how we respond to medications would also be different based on the genetics. So that's what it really is in a nutshell, it's just taking into account the genetic information to make a more informed medical decision. I always say the other clinical factors when choosing a medication. They're also very important, so we're not forgetting about those. But this is just giving the providers and the pharmacists just an additional tool in their full belt to really know how to choose the right medication for the patient. And I think Go ahead.
Speaker 2:No, go ahead.
Speaker 1:When let's edit that out, brisa when was pharmacogenetics, I want to say, discovered or started to be implemented in the patient journey?
Speaker 2:That's a great question. So we have known about pharmacogenomics for a long time. I mean more than 50 years of research. However, it really became more popular when the project for the human genome was completed in 2000. So it's actually over 20 years now it's. You know, think about that and we're like, oh, that just was yesterday, but it's a little over 20 years ago and that's when we first started seeing some of this become more popular in actually how to implement it in the clinical practice. But really it has taken off, I want to say, in the past five to 10 years, where there's still a lot of, you know, gaps in implementations and it's not available everywhere. Now. Mainly it's going to be available in health centers that have started to do research with it and then have integrated patient care. But it's not a routine screening just yet. So still, you know, there's a long way to go in terms of integrating it in the majority of the US and even the world.
Speaker 1:So I have so many questions because, first, if we've known about this for two, three, four decades, five decades, then why isn't this not more mainstream? I'm wondering what are the roadblocks that get in the way of utilizing pharmacogenetic testing?
Speaker 2:Yeah, so one of the main roadblocks is really the cost. So insurance companies they're not on board with it 100% just yet. Actually, in the recent years, so in the past five years we see more insurance coverage coming on board, especially UnitedHealth. They started covering it a few years ago and then now in California MediCal, they just passed a ruling to have pharmacogenomics covered next year. So we do see a little bit of that coming today nowadays and I hope that this can open up a little bit more of the access. But one of the main issues is the cost and not being covered by insurance.
Speaker 2:Another big issue and I also saw this in some of my research is the education. So, like we mentioned even at the beginning of the call, you don't learn about this in school and the medical doctors, they don't necessarily learn about this, but even in pharmacy schools, I mean, it's being introduced now a little bit more. And, esha, I definitely think you were lucky that you had that component in curriculum, because 10 years ago it definitely wasn't as widespread. But just the medical professionals, they don't necessarily feel educated enough or feel ready to implement it. So then there's that question of well, I don't want any liability. I have this information but I don't know how to use it. So that's also another barrier there. But I've seen especially that's why I'm really hopeful for it as we move forward here, because I've seen a lot more medical professionals be interested in it and actually do certificate courses like ours and other courses to educate themselves and apply this to patient care. Also, patients patients are getting more educated about actually asking their providers for the test.
Speaker 1:I can see that the liability purposes. When you have information but you don't know what to do with it, I guess that could be a barrier. But on the flip side, when you do have information, what opportunities could that open up?
Speaker 2:Yeah. So that can definitely open up a lot of opportunities in terms of applying the information that you do have for better medical management. And you know we're thinking about this in that, in the area of oh, I have this information, you know I don't want it because I don't want liability, but at the same time, you can actually maybe open yourself up for more liability if you don't test, because this information is available and you can be using it for patient care.
Speaker 2:And there was actually a recent case for cancer medication where one you know this his wife, her husband, was. He had cancer and he actually ended up dying because of the side effects of cancer. And she was looking into it and found out that there was this test, the pharmacogenomic testing that they could have done to save his wife and then look at, you know, so they could find the right dose for him. So she sued the hospital and settled for a couple of million dollars and now, yeah, so then now the hospital has to, of course, test for that gene and educate all of their providers. So there's, there's that risk with it as well.
Speaker 1:Well, yeah, I hate for that to have to be the impetus of change, right? Someone getting injured, obviously death occurring, and then a lawsuit, but you know you can't. That's how a lot of people learn. But where is this in standardized practice today? You know, if I were to get diagnosed with something, how would I know at what point do I need to get tested?
Speaker 2:Yeah, that's that's a great question, and you know, to be completely honest with you, there isn't a good system right now for for a patient to to really know where well, where do I get tested? You're just gonna have to do more research yourself online and if you happen to you know to have that this medical center that you're at offer the testing, then that that would be a good opportunity there. In terms of who should get tested, I think that everyone should get tested, regardless of whether they're taking medications or not, and the reason for that is because you'll have this information available to you and then you can use the information to decide.
Speaker 2:Okay, so in the future, if I'm ever, you know taking any medications, I will use this information to know whether I should be taking any medications, whether I should be taking the drug or not, because your genetics never change. Yeah.
Speaker 1:So I mean, are what are you saying that? A healthy person? And I'm just trying to learn here, you know what point? Because it's either I'm taking care of my mom or I'm taking care of my kids, and then I'm in the middle. So or patients and pharmacists listening, they're taking care of their patients, but then they're also thinking about themselves, or they're thinking about their family. So at what I mean, I guess, at any point you can, just you can get tested and then you have results of what your genetic profile looks like, and then do you bring that to your PCP or your general provider or pharmacist that you're looking, working with. What do you do, I guess, after you get tested?
Speaker 2:Yeah, so that's that's also a great question and right, you're, right, you're, sometimes we don't, we don't think about ourselves. Right, we're thinking about all the people I have to take care of, and the test can definitely be very helpful for anyone that is not taking any medications or doesn't really have anything going on. And with this will, you know, kind of depend on the different companies, but what we do is we'll actually sit down with every single patient that has the test, that does the test, and have a consultation with them so that they can understand what you know, their their pharmacogenetic results, and then we reach out to their providers to share the results with with their providers and actually schedule one on one meetings with them as well. If there's anything that we need to change, then we'll have a meeting with a provider, share the recommendations and then, if they're interested in learning more, we also offer educational webinars for them as well.
Speaker 1:So that's awesome. So how does the test work? What is the process?
Speaker 2:So it's really easy. We send it to. The patient orders the test online or through their provider. We definitely need to have a provider there just to make sure that the patient is not making any medication changes on their own. That's why we always talk to them as well. There's always a pharmacist medical provider that's really trained in the middle there and once they order the test, we ship it over to them. It's a really easy, chick swap.
Speaker 2:It takes about a minute to complete and they send it over to us. We provide all the shipping labels and everything and then we will run it through the lab. Once the results are available the provider or the pharmacist who submitted that request they will get a notification that the results are available. So then we usually will schedule an appointment with the patient to go over those results and then from there share the information with the provider.
Speaker 1:Okay, cool, awesome. I feel like everyone's going to stop listening to this recording. And one look at our education on what this test is and then two go out and test themselves or their patients. Yeah, absolutely, I mean, obviously that's the goal. But let's talk a little bit about the course and how and what it's structured and what it's intended to be and what it's intended not to be. So share with us a little bit about the kind of the education, of what's involved in the course that we put together.
Speaker 2:Yeah, so the course it's eight hours C credits, so it's a little bit more involved there, and it's really meant to be an introduction to pharmacogenomics and give you the resources that you need to apply this information to patient care. So it's a very good basics for pharmacogenomics, especially if you're not familiar with it and you haven't had it in school. But if you have had it in school, this will definitely solidify some of those concepts. So it takes you through a few different medication classes that are the most commonly prescribed and also that are affected by pharmacogenomics. But the most valuable thing about the course is that it really provides you with resources that you can use later on as well If you want to apply this information to your patients.
Speaker 2:So, coming out of the course, you should really feel comfortable with knowing you know having an introductory basis on pharmacogenomics, understanding how the lab works and how do you choose a lab and how do you choose a partner, but also having the right information and the right resources to apply this to patient care. Because you can have a course and the information we have there it's updated based on the current information that we have but then how do you? What about two or three years down the path you're like. Well, how do I use this now? Because, made this information is not updated, so the course really does a great job of pointing it to the necessary resources so that you're always updated.
Speaker 1:Yeah, and what type of pharmacist this is? A pharmacist course or pharmacist course, a course that is geared towards pharmacists in particular? What type of pharmacist do you think should be educated on this type of content or this type of education, training?
Speaker 2:I think all pharmacists, no matter what they do, they should definitely be educated on this.
Speaker 1:That's a good answer.
Speaker 2:I hear you. Well, because it's in the name. It's pharmacogenomics. Pharmacy is the name. So we really need to own the space. We were trained for it in some level, because we already understand kind of half of the battle here, which is we understand drugs and we also have been trained in pharmacokinetics. But then the piece that, and then again the course does a really great job at this. The piece that's missing is okay. So how do I add genetics? How do I supplement with what I already know about drugs and how they're metabolized? How do I also incorporate genetics into this?
Speaker 2:So I think it's a very seamless transition for the pharmacist to really own the space and be that expert and that educator for the providers so that they feel more comfortable and we just help out more patients.
Speaker 1:Comfortable and confident in using the knowledge, the information that is produced by the test correct.
Speaker 2:Yes, exactly.
Speaker 1:And do you think it's because it's a change from common practice?
Speaker 2:Yeah, so it is a change from standard practice. But also pharmacists notice, especially if you work in community pharmacy, you just have a lot going on.
Speaker 2:It's just really busy, so it might be a little bit more difficult to learn or incorporate new things. And you think, oh this pharmacogenomics this is a long word must be extremely complicated. There's no way that I can learn about this in eight hours. But you really can and it can really make a difference for the patients because, like I said, we already understand the pharmacy part of it, which is more than half the battle.
Speaker 1:Yeah, and to me it sounds, the more and more I'm getting to know you and getting to know your level of expertise and just learning about the content and pharmacogenetics itself. It seems almost it's essential part of the pie. It's an essential piece of the making sure we're doing everything we can to get the right medication to the right patient at the right time at the right dose. All that you know the whole thing and to me this seems almost Like we have to do this. This is part of managing the medication regimen. So this is great. I'm excited for people to enroll, I'm excited for the update to go live in this month and you know, having experts like you on our faculty expert panel is essential for us to make stand out Not just CE but really advanced training that helps pharmacists just help patients.
Speaker 2:So you know appreciate your time.
Speaker 1:We really love working with you. You've been such a value add to our company, to our audience, to our customers. So we appreciate you and your level of expertise. And I know I am in between you and your vacation, so I am your last stop. So I want to wrap up and say thank you so much and if anyone wants to reach out to Ina, wants to enroll in the course, I will link all of the content and all of the information inside our show notes. So, Ina, appreciate your time and you know you're always welcome back to level up and see impact.
Speaker 2:Well, thank you. Thank you so much, Ashley. It's been great working with you as well and I'm just I'm really passionate about pharmacogenomics, Like I said, ever since I learned about it. I said I really want to learn how to do this and implement and just know more, because I definitely agree with you that it is, it is essential and just that, you know puzzle that's missing from how we do patient care. So, thank you so much for having me. It's been, it's been a pleasure and, yeah, like Ashley said, if anyone has any questions for me or wants to learn more, feel free to reach out to me. Thank you Awesome.
Speaker 1:Thank you so much. Appreciate you guys.