Meet Dr. Robin Everts
Dr. Robin Everts, PGx expert and advocate, has spent the last 10 years partnering with thought leaders to advance the field of pharmacogenetics. In addition, he is an active member of the Clinical and Laboratory Standards Institute. Dr. Everts has worked with countless newly-forming and well-established PGx labs, often focusing on how to manage the cost of PGx testing.
Cost is a critical consideration for any PGx testing program. Testing costs must be balanced with revenue and budgets to maintain a sustainable program. However, despite careful planning, technology inefficiencies can unexpectedly increase costs. These unplanned expenses can threaten a testing program’s viability.
During his time working with PGx laboratories, Dr. Everts has identified a handful of common challenges that can drive testing costs two to three times higher than what was originally expected: reagent cost and waste, equipment amortization, multiple replicates per sample, multiple workflows, and multiple samples.
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Dr. Everts makes the following recommendations for overcoming the high costs of PGx testing, to ultimately create a cost-effective PGx testing program.
This may seem obvious, but it is worth mentioning. The “upfront cost per test” is the cost for reagents, equipment amortization, and anything else you need to process a single sample. Different technologies can have very different costs. Choose a vendor that offers a reasonable upfront price.
Assay drop-out is a challenge for many PGx technologies. Failing assays result in incomplete genetic information that cannot be reported. To meet their turnaround time obligations, labs are forced to run 2 or 3 replicates for each sample to ensure a complete set of results is obtained on the first pass. That reasonable cost per test has now doubled or tripled. Avoid multiple replicate requirements. Ask if others using the technology run multiple replicates per sample. If they do, consider going another direction.
Paying for unused reagents is a quick way to balloon costs. Remember that the cost per test provided by the vendor assumes perfect 100% reagent utilization. Most pre-filled cartridges and similar consumables can only be used once. If only part of it is used, the rest is wasted. This can be especially challenging for newer programs that are still building their testing volume. Fewer samples and higher-than-expected costs are a challenging combination to overcome. Learn about a technology’s reagent format. Are reagents used only when samples are run or must they be batched? If you process a smaller number of samples, how much will you pay for unused reagents? Look for technologies that minimize waste when sample volumes don’t match the optimal batch size.
“ If you process a smaller number of samples, how much will you pay for unused reagents? Look for technologies that minimize waste when sample volumes don’t match the optimal batch size.”
– Dr. Robin Everts, PhD, PGx expert and advocate
Many PGx programs need genotyping and copy number information to make their recommendations. Unfortunately, this often means using multiple platforms, which increases cost and kills lab efficiency. Even if a single platform can perform both procedures, it may still require separate workflows. Consolidating genotyping and copy number variations to a single setup procedure, run, and instrument will save precious time and money.
To get an accurate copy number call, some methods require 3-4 replicates per sample for every assay that is used. Given the importance of detecting CYP2D6 hybrid alleles, labs are testing 3 or more assays per sample to get broader gene coverage. That can mean running 12 replicates for every sample for copy number results alone. Avoid the extra expense by choosing a technology that can accurately provide copy number data with one assay using a single replicate.
Explore the MassARRAY® System for PGx Testing
PGx testing with Agena’s MassARRAY System provides affordable upfront costs with minimal unexpected extras. No duplicate samples. No reagent wastes. Single assay copy number detection that can be run side-by-side with genotyping.
Explore Our PGx Panels – Whether you’re just getting started or already have a well-established testing program, Agena’s PGx solutions deliver best-in-class accuracy and flexible panel content while minimizing testing costs. Simultaneous genotyping and copy number detection enable labs to implement a single, comprehensive PGx testing workflow.
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