Who Are Adopters of Pharmacogenomics among U.S. Physicians? E. J. Stanek1, C. L. Sanders1, J. R. Teagarden1, K. A. Johansen2, R. E. Aubert1, B. C. Agatep1, M. Khalid1, A. Patel1, F. W. Frueh1, R. S. Epstein1 1) Medco Health Solutions, Inc., Franklin Lakes, NJ; 2) American Medical Association, Chicago, IL.
Background: Information about pharmacogenomics (PGx) is evolving rapidly, but little is known about how US physicians perceive and use PGx testing. Methods: We conducted an anonymous, cross-sectional survey of US physicians in late 2008. The fax-based survey solicited demographic and professional profile elements, as well as PGx education, beliefs, practices, and preferred information sources. Respondent characteristics were compared to the American Medical Association MasterFile to assess generalizability. Factors associated with early and future adoption of PGx were tested for statistical significance with chi-square and multivariate logistic regression analyses. Results: We surveyed 397,832 physicians and 10,303 (3%) completed surveys were returned. Respondent characteristics were similar to the overall US physician population. Overall, 98% of respondents agree that patient genetic profiles may influence drug therapy, and 26% have prior PGx education. However, only 10% feel adequately informed about PGx testing. Early adopters (those ordering a PGx test in the previous 6 months) accounted for 13% of respondents, and future adopters (those anticipating ordering a PGx test in the next 6 months) accounted for 26%. Ten percent of respondents reported that PGx tests had benefited their patients by improving drug effectiveness and 10% reported their patients benefited from reduced toxicity. Early adopters are more likely to be oncologists, 15-29 years from medical school, and recipients of formal PGx education. They are also more likely to feel adequately informed about the availability of genetic testing, and believe that tests have benefited their patients by improving drug effectiveness, reducing drug toxicity, or increasing patients understanding of therapy. Physicians who had not yet adopted PGx testing, but anticipated doing so, were more likely to be male, older, and educated about PGx. They also believe that a patients genetic profile influences drug therapy and that the use of PGx tests benefit patients by improving drug effectiveness or reducing toxicity. Conclusions: An estimated 13% of US physicians have adopted PGx testing, while 26% anticipate adoption. Surprisingly, almost all believe that a patients genetic makeup influences drug therapy. The contrast between acceptance of PGx as a therapeutic modifier and actual adoption rate highlights the need to clearly demonstrate patient benefit and the importance of physician education.