BlueCross BlueShield of Tennessee Medical Policy Manual

Pharmacogenetic Testing for Pain Management


Pharmacogenetic testing combines pharmacology and genomics with the intent of discovering effective and safe medications and doses tailored to a person’s genetic makeup. A number of commercially available panel tests (e.g., GeneSight® Analgesic, Proove® Opioid Risk Panel,  Pain Medication DNA Insight™, Millennium PGT™, IDgenetix®) have been proposed as an aid in pain management.

Individual or panel tests relevant to pharmacogenetics could include testing of the following genes:


See also:



No high quality studies were found in the published literature that validates the use of pharmacogenetic testing for the treatment of pain. At present, the clinical utility of pharmacogenetic testing in pain management is poorly defined.


American Academy of Neurology. (2014) Opioids for chronic noncancer pain a position paper of the American Academy of Neurology. Neurology®, 2014 (83), 1277-1284.

Bell, G. C., Donovan, K. A., & McLeod, H. L. (2015). Clinical implications of opioid pharmacogenomics in patients with cancer. Cancer Control, 22 (4), 426-432. (Level 4 evidence)

BlueCross BlueShield Association. Medical Policy Reference Manual. (5: 2017). Pharmacogenic testing for pain management. (2.04.131). Retrieved March 27, 2018 from BlueWeb. (56 articles and/or guidelines reviewed)

Crews, K. R., Gaedigk, A., Dunnenberger, H. M., Leeder, J. S., Klein, T. E., Caudle, K. E., et al. (2014) Clinical Pharmacogenetics Implementation Consortium Guidelines for Cytochrome P450 2D6 Genotype and Codeine Therapy: 2014 Update. Clinical Pharmacology & Therapeutics, 95 (4). (Level 5 evidence)

Jannetto, P. J., & Bratanow, N. C. (2009). Utilization of pharmacogenomics and therapeutic drug monitoring for opioid pain management. Pharmacogenomics, 10 (7), 1157-1167. (Level 4 evidence)

Kapur, B. M., Lala, P. K., & Shaw, J. L. (2014). Pharmacogenetics of chronic pain management. Clinical Biochemistry, 47 (2014), 1169-1187. (Level 2 evidence)

Scarpi, E., Calistri, D., Klepstad, P., Kaasa, S., Skorpen, F., Habberstad, R., et al. (2014). Clinical and genetic factors related to cancer-induced bone pain and bone pain relief. Oncologist, 19 (12), 1276-1283. (Level 3 evidence)

Winifred S. Hayes, Inc. Genetic Testing Evaluation. (2014, November). Cytochrome P450 genotyping to predict response to opioid pain medications. Retrieved April 15, 2014 from (44 articles and/or guidelines reviewed)




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