Taking genetic test can help epileptics save money

SINGAPORE - A genetic test costing $200 can help epileptics in Singapore save a handsome sum in the long run, especially for the Malays and Chinese.

The genotype test, to identify certain genetic patterns, however, does not benefit Indians as much, Singapore researchers found.

Still, it is enough to spur the Health Sciences Authority (HSA) to tweak the information contained in drug packages. It is also considering making genetic testing compulsory for new patients.

Epilepsy is often kept in check with medication, but the two most commonly used drugs - carbamazepine and phenytoin - can trigger serious side effects. These include two life-threatening skin disorders, known as Stevens-Johnson Syndrome and toxic epidermal necrolysis.

Symptoms include blistering and skin detachment. Up to 30 per cent of those who suffer from skin necrolysis may die.

But genotype tests can help detect the presence of a specific type of genetic sequence, called an allele, in the person's DNA. This can help predict if the epileptic will react adversely to the two drugs.

That is why researchers at Duke-NUS Graduate Medical School embarked on a study to determine if going for the test will be cost-effective for the three ethnic groups.

They found that Malay and Chinese patients who were tested would save more in the long run, compared with what they do now, which is to take the two drugs without taking the genotype test.

This is because the use of alternative drugs, despite being more expensive, remains cheaper than paying to treat the skin disorders.

PhD student Dong Di, the lead author of the study, said: "The results of this study speak of the value of stratified medicine - giving different people different drugs or treatment, based on genetic variation."

The study was published last month in Neurology, the official scientific journal of the American Academy of Neurology.

Epilepsy, a disorder of the nervous system, where sudden electrical surges in the brain cause seizures, affects one in 100 people.

The new findings have prompted the HSA to look at changing the package inserts of the two drugs. "We are going through this exercise right now, consulting with a number of stakeholders - neurologists, patient groups - to get the exact wording correct," said Adjunct Assistant Professor Cynthia Sung, a visiting consultant at the HSA.

chpoon@sph.com.sg


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