Genetic Testing?

[hith]

Hi all,

I'm new to this forum, forgive me if this has already been asked. I was just contacted by my insurance company about a genetic test to determine the right warfarin level for me. Has anyone else had any experience with these tests? Do they actually work or is this a waste of time/money for my company to pay for?

 

[catwoman]

I'm not aware of anyone here who has had the testing. I have not heard how much it costs. Or how accurate it is. If my memory serves me right, that genetic test might not be useful for everyone. I'm sure someone will set me straight if I'm wrong.
That "right" level might be OK for initiating anticoagulation therapy -- but it will vary after that, due to additions of/changes in other meds, dietary swings, starting/quitting strenuous activities, etc.
Instead, I would explore with your doctor(s) and insurance company getting your own INR testing machine. That would enable you to stay on top of INRs that would call for changes in your warfarin dosage. Home-testing has hleped many of us stay in range. My family doctor is a fan of home-testing. He has sometimes prescribed a med or injection that might affect my INR; he just says, "Since you have your own testing machine, you can stay on top of that."

That's just my $0.02 worth.

 

[Philip B]

Testing

Testing

I've probably heard more references to genetic testing to find out if people can tolerate coumadin during the last six months than I've ever heard before. I've even heard commentary from a couple Denver area television stations. I'm not sure what's up with that.

I don't know much about testing because as an artificial valve reciepent, I don't have much choice but to take coumadin. I've heard varying reports about the expense of testing and what insurance companies will actually cover.

If I were trying to decide whether a tissue or mechanical valve was the best fit for me, I'd probably consider getting tested. It would be a real bummer to get a mechanical valve and findout that coumadin is something I couldn't tolerate. Part of this thought is simply the result of some of the hype that I've heard lately; I'm not even really sure how often genetic coumadin intolerance becomes a problem. If this was something that happened often, I'm sure my cardiologist would've visited with me about it.

-Philip

 

[Maryka]

Very interesting! I went into use of Coumadin with no known genetic testing and I SURVIVED, LOL. I think a lot more genetic testing would be good to discover which of us can have our heart valves repaired or replaced w/o worrying about more things (such as developing aneurysms and other seemingly Marfan-like things going wrong). With the disappointing healthcare plan I was stuck with when I went on COBRA, I learned the hard way that Warfarin is my least expensive medication. Because of how inexpensive Warfarin is, I am amazed your insurance really cares!

 

[Ross]

Genetic testing doesn't tell you how much you'd take. It only tells whether or not your highly sensitive to Warfarin and would require smaller or larger doses. It's much cheaper to simply start you on 5mg a day, test you after 4 days to see where your at and adjust from there.

The test itself is around $800, down from several thousand a couple years ago. Most insurance companies will not cover the genetic testing.

http://www.clotcare.com/clotcare/warfaringenetictesting.aspx

What has me laughing about this is, they are so worried about bleeding events, not strokes, but yet none of them are on the same page and in all honesty, are mostly responsible for the bad things that happen. They simply will not take ownership of the fact that they do not know how to dose properly. If those of us that home test and self dose can understand it, why can't they?

 

[lance]

Timely topic
An 82-year old relative of my sisters began taking warfarin for A-fib about 6 weeks ago. She is complaining about sore, purple toes/feet. Her doctor is aware of her condition.
I think she should be tested for warfarin intolerance if it isn't already too late. In a perfect world she would have teen tested prior to taking it. I don't think this test would help determining what does would be correct for her.

 

[catwoman]

Timely topic
An 82-year old relative of my sisters began taking warfarin for A-fib about 6 weeks ago. She is complaining about sore, purple toes/feet. Her doctor is aware of her condition.
I think she should be tested for warfarin intolerance if it isn't already too late. In a perfect world she would have teen tested prior to taking it. I don't think this test would help determining what does would be correct for her.

Perhaps this woman has had a very rare side effect to warfarin called purple toes syndrome. Determining the correct initiating dosage might not have helped.

Read:

http://www.medscape.com/viewarticle/455759

 

[lance]

Thank you Marsha,
I'm passing the message/link along.
Sandra