Cytochrome p450 Genotyping
DESCRIPTION
Cytochrome p450 genotyping represents a type of pharmacogenetic test intended to predict therapeutic failures and severe reactions to some commonly prescribed drugs based on the individual's ability to metabolize the drugs. It has been proposed that this test be performed prior to the initiation of a drug to determine adjustment of dosages based on genetic factors.
POLICY
Cytochrome p450 genotyping for the prediction of therapeutic failures and / or severe reaction in the choice of drug or drug dosage is considered investigational.
See also: Genotyping for Chronic Hepatitis C
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
Evidence is insufficient to permit conclusions regarding the use of cytochrome P450 genotyping for the prediction of therapeutic failures and / or severe reaction in the choice of drug or drug dosage.
SOURCES
BlueCross BlueShield Association. Medical Policy Reference Manual. (5:2007). Cytochrome p450 genotyping (2.04.38). Retrieved January 15, 2009 from BlueWeb. (34 articles and/or guidelines reviewed)
ECRI Institute. Health Technology Information Service. Emerging Technology (TARGET) Evidence Report. (2008, August). Genetic assay for warfarin response. Retrieved January 15, 2009 from ECRI Institute. (24 articles and/or guidelines reviewed)
National Guideline Clearinghouse. (2008, November), Recommendations from the EGAPP working group: testing for cytochrome P450 polymorphisms in adults with nonpsychotic depression treated with selective serotonin reuptake inhibitors. Retrieved January 15, 2009 from http://www.guidelines.gov.
Technology Evaluation Center. (2004, December). Special report: Genotyping for cytochrome p450 polymorphisms to determine drug-metabolizer status (Vol. 19, No.9). Retrieved March 21, 2007 from http://www.bcbs.com/betterknowledge/tec/vols/19/19_09.html.
U. S. Food and Drug Administration. (2004, December). Center for Devices and Radiological Health. Approval letter: AmpliChip CYP450 test. Retrieved June 20, 2005 from http://www.fda.gov/cdrh/pdf4/k042259.pdf.
ORIGINAL EFFECTIVE DATE: 11/12/2005
MOST RECENT REVIEW DATE: 3/12/2009
ID_BT
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