Bridging the Gap: Pharmacists' Role in Advancing Pharmacogenomic Testing Standards

Pharmacy Times interviewed Raymond Lorenz, PharmD, BCPP, director of Medical Affairs at UGenome AI in Daphne, Alabama, on his participation in a workshop on laboratory challenges at the Standardizing Laboratory Practices in Pharmacogenomics (STRIPE) Annual Meeting and Consensus Workshop at the headquarters of US Pharmacopeia (USP) in Rockville, Maryland.

Key laboratory challenges discussed during the workshop included deciding which genes and alleles to test for, ensuring regular updates, and disseminating standards to clinicians and payers. Lorenz expressed hopes for the meeting to produce foundational consensus statements addressing key issues and fostering stakeholder discussions.

Lorenz emphasized the vital role pharmacists play in bridging the gap between laboratory results and clinical application, helping translate genetic data into actionable medication decisions. Pharmacogenomics has broad applications in fields such as oncology, psychiatry, and infectious diseases, where pharmacists’ interdisciplinary knowledge enhances collaboration with other specialists. Lorenz encouraged pharmacists to recognize the significance of emerging standards, understanding their iterative nature, and engaging with the evolving dialogue among diverse stakeholders.

Pharmacy Times: Could you share an overview of your workshop at the STRIPE Annual Meeting?

Raymond Lorenz, PharmD, BCPP: Sure. So, I'm part of the laboratory challenges workshop, which we are looking at figuring out, regarding pharmacogenomic testing, implementing and deciding on which guidelines and whatnot should be included for all laboratories. Basically, developing a consensus statement regarding which guidelines should be used, how we should use them, all of that kind of stuff. So that's kind of the general gist of it.

Pharmacy Times: What are some key takeaways from the conference regarding pharmacogenomics?

Lorenz: I think that one of the biggest challenges we have within the laboratory space is defining which alleles, which genes, we should be testing for. Part of the laboratory challenges workshop is really looking at and trying to define, how are we going to decide which genes and which alleles to include? Are we going to look at guidelines? Are we going to look at clinical practice? What are we going to do? So that was the one of the big, I guess, overall questions that we had. You know, other questions include things like, well, how do we keep updated updates going, and how do we make sure that these get disseminated to other people, and that payers and clinicians and everybody kind of know about what these standards are going to be? Those are some of the things we're tackling now.

Pharmacy Times: What is the role of pharmacists in pharmacogenomics?

Lorenz: That's actually a good question, because I think that having a pharmacist in a laboratory space is definitely unique, but I'd say that about half of my colleagues that I work with are PharmDs or pharmacists, and the other half are PhD-level MDs, that kind of thing. And so, I mean, there are a fair number of us there, and I think that the biggest thing that pharmacists bring to the laboratory space is really knowledge of what the laboratory results mean for a clinician and how to use that information to make better medication decisions for patients. I think that there are a lot of labs that don't have that connection, that they report out certain things, and it's like, “okay, great. Well, what, what does that mean as a clinician?” I don't know, right? I think the pharmacist comes in and bridges that gap for people.

Pharmacy Times: What are your hopes for what can come out of this meeting regarding laboratory consensus challenges?

Lorenz: I'm hoping that we can kind of coalesce around maybe 2 or 3 big issues that have been going on and figure out, at least put something out that people can comment on, so that we have a discussion going. [We want people to know], hey, pharmacogenomics is a thing, right, number 1. But then number 2 we're working towards getting standards going so that everybody can not necessarily be the same but know what those standards are and what best practices are, I guess you'd say.

Pharmacy Times: Are there any specific disease states involved in your work in pharmacogenomics?

Lorenz: So, yeah, it's a good question. So, I feel like there are lots of different applications for pharmacogenomics. I think, obviously you mentioned one of the biggest ones is oncology, and obviously other big ones, things like psychiatry, neurology, rheumatology, infectious disease. That's one of the other reasons I think pharmacists are really good, is because we have a broad knowledge about different disease states, and we're able to bring that information to talking to oncologists or talking to psychiatrists, because we have that knowledge, that medication knowledge, and [it] gives us that authority to talk to them about that stuff.

Pharmacy Times: What should pharmacists understand about the key points from this meeting?

Lorenz: I think that, because this is a kind of multi-disciplinary conference, we have lots of different stakeholders that are here. We have payers and labs, and clinicians and researchers, and so we're all kind of coalescing, hopefully, around these big statements that we can make. I think that knowing that these statements that are coming out are not going to be perfect, right? They're not going to be applied to everybody all the time. I think that it's a good point of discussion to start and acknowledge that, “Hey, we're trying, we're going to get there eventually.” The statements that we come out with may not be exactly what we think that they should be, but hopefully we'll get there with enough participation from everybody and all the stakeholders.