Improved Antidepressant Remission in Major Depression via a Pharmacokinetic Pathway Polygene Pharmacogenetic Report

The World Health Organization predicts that major depressive disorder (MDD) will become a leading cause of disability globally by 2030.1) Reducing the burden of this ease from MDD is a public health priority, yet it appears the per capita level of disability from MDD globally is increasing.2) Antidepressants have assisted treatment of more severe MDD, with demonstrated superiority over placebo.3) Unfortunately, 30-50% of patients do not respond (at least a halving of the depression rating scale score),4) to their first antidepressant trial.5-10) Remission (return of the rating scale to normative levels; e.g., 17-item Hamilton Depression Rating Scale [HDRS] ≤7) is clinically a more translatable efficacy measure as those who respond but fail to remit tend to relapse.4,11) Remission not response is the pathway to recovery from MDD.

Combinatorial Pharmacogenomic Testing Improves Outcomesfor Older Adults WithDepression

Geriatric depression, which affects approximately 5% of older adults (age ≥65 years) in the United States,1,2 places substantial burdens on function, quality of life, and healthcare resources. In 2017, 2.2% of U.S. men and 3.5% of women age 65 years or older had experienced a major depressive episode in the past year, according to the U.S. Substance Abuse and Mental Health Services Administration.3 Although major depressive disorder (MDD) episodes are less prevalent in older adults than in younger age groups,1 up to 15% of community-dwelling people in this age category experience clinically significant depressive symptoms, with higher rates of MDD and depressive symptomatology among those in medical settings.1 Depression among older adults is linked with longer length of illness, more frequent MDD recurrences, and a greater risk of comorbidities.4,5 In this population, depression is the psychiatric illness most closely associated with suicide,6 the rate of which climbed to a high of 17.2 per 100,000 individuals in 2018.7 A broad range of clinical and social factors adds complexity to its presentation and medical management. Therefore, the diagnosis and treatment of geriatric depression warrant special focus.

Cost–effectiveness of combinatorial pharmacogenomic testing for depression from the Canadian public payer perspective

Depression is a significant health and economic burden in Canada. In addition to the impact of depression on patients’ health and quality of life [1], it costs the Canadian economy more than CAD $32 billion annually [2].The cost of depression stems directly from increased healthcare resource utilization and indirectly as a result of increased disability and absenteeism [3,4]. For example, the direct and indirect per-patient costs were 3.5 and three-times higher, respectively,