GeneSight Review: Can DNA testing improve mental health?

Overview

1. Products: GeneSight’s primary offering is pharmacogenomics testing – DNA tests that are clinically undertaken and administered to assess how a patient will be affected by certain antidepressant medications based on their genes.
2. Cost: GeneSight partners with insurance companies and clients’ coverage programs to minimize the costs of testing; they claim most users pay $330 or less for their tests.
3. Reports: GeneSight reports are fairly simple, showing which medications from their pre-formed database a patient’s genes are likely to interact with. The reports also show further, complex clinical analysis and causal relationships between particular genes and medications.
4. Raw Data Access: GeneSight testing does not provide users with their raw genetic information.
5. Privacy: GeneSight does collect user personal information which they attest is used for marketing and promotional purposes. Clients of the company must proactively email GeneSight customer service should they wish to have their data deleted.
6. Alternatives: SelfDecode offers personalized health recommendations based on an analysis of up to 83 million genetic variants.

Pros

• Although a still blossoming area of research, GeneSight offers a unique service—pharmacogenomic testing—one not provided by many other biogenetics companies.
• GeneSight works directly with general practitioners and healthcare providers which means that the results of your tests, and the conclusions of your report, are not just generally reputable but clinically significant as well.
• Because GeneSight collaborates with insurance companies, there is potential for a reduced testing cost for most users.

Cons

• Some questions have been raised about the scientific legitimacy and or significance of psychotropic research and its efficacy in treating disorders related to depression. That said, GeneSight affirms the veracity of the clinical research it cites.
• GeneSight testing is exclusively used as a diagnostic and treatment guiding tool for clinicians; GeneSight does not provide users with raw genetic data files, health recommendations, or any other useful information relating to their genes.
• GeneSight shares some client information with other companies, although they maintain that those third parties must comply with the relatively strict privacy-policy of their parent company, Myriad Genetics.

About GeneSight

GeneSight is part of a larger conglomerate, and well-established biogenetic company, Myriad Genetics. Myriad has long been focused on molecular research as a way to improve patient care and extend the ability of doctors and healthcare providers to offer increasingly intuitive treatment methods. Myriad was founded by previous CEO and President Peter Meldrum, Walter Gilbert, Kevin Kimberlum, and Mark Skolnick.

Their current President and CEO is former Kindred Healthcare CEO, Paul J. Diaz. Myriad made a name for itself in 2013 when a supreme court lawsuit ensued over its attempts to patent human genes related to ovarian and breast cancer. Since then, it has made ambitious endeavors into various molecular diagnostic fields, with GeneSight serving as their entry point to the realm of pharmacogenomics and neurotherapy.

Overview of GeneSight Testing

The GeneSight testing process is relatively simple, both because tests are often conducted with the help of one’s general practitioner and also because the tests seek to identify a very narrow set of genetic information.

In short, GeneSight’s psychotropic test analyzes how you might respond to a variety of medications used to treat depressive and mood disorders, for example, ADHD, by assessing your genetic makeup. There are a plethora of common medications which GeneSight’s psychotropic testing checks for. A table with the included medications can be seen below.

The tests GeneSight administers are meant to inform your clinician about which medications might be more compatible with your biology than others, which ones might be more prone to cause adverse side-effects, and what sort of dosage might be appropriate.

Until recently, the tests could only be ordered by your clinician and carried out under their supervision. However, as of July 2020, Myriad Genetics has announced they are launching a new patient home collection test kit which, although still needing to be ordered by a physician, can be taken independently.

Review of GeneSight Test Reports

Critical to note about the GeneSight psychotropic reports is that they are intended for clinician use even if the test itself has been undertaken by an individual at home. The implication is that these test reports are created for an audience of medical doctors who can then relay the information to their patients and make more educated decisions about what kind of treatment is appropriate to pursue.

There are two kinds of genes which get reflected on GeneSight reports:

• Pharmacokinetic Genes, which demonstrate how the body acts upon medications
• Pharmacodynamic Genes, which indicate how the body will be affected by such medications

GeneSight reports are several pages long. The first page convey which medications a patient could be normally prescribed, which have a moderately altered effect based on genetic makeup, and which produce a more significant gene-drug interaction.

The next page of the report offers clinical considerations to be reviewed by the doctor. These provide reasons for the medication’s listing in a particular category and also provide suggestions about how the medication should be administered if the practitioner wishes to pursue it as a treatment option.

The next two pages of the psychotropic report list the patient genotypes which are of medical significance, first for the patient’s pharmacodynamic genes and followed by their pharmacokinetic genes.

The pharmacodynamic genes of consequence are listed and their relationship with certain disorders is described. Similarly, on the latter page, the patient’s relevant pharmacokinetic genes are cataloged and categorized based on their metabolization potential. This offers information about how a patient’s body might process certain medications with respect to ease and quickness. The pharmacokinetic analysis page is displayed below.

The final page of the report is dedicated to a gene-drug interaction chart which represents the overall network of genes that affect a patient’s reaction to certain medications. It indicates drugs that are recommended that the patient use as directed, those for which the patient displays a moderate gene-drug interaction, and for which there is a significant potential for gene-interaction.

This gives the practitioner a more comprehensive overview of the patient’s potential reactions to a variety of different treatment options, allowing them to assess which are more viable than others. The chart can be viewed below.

The GeneSight reports would undoubtedly be difficult to interpret or make use of for the average person seeking insight about their genetic predispositions. Once again, however, these psychotropic reports are meant to function exclusively as diagnostic tools for medical doctors.

GeneSight does not attempt to make health, wellness recommendations, nor even display generally accessible information about a client’s genetic makeup through their reports because the purpose of such tests is entirely clinical.

GeneSight Cost

The number which GeneSight establishes as a waypost for their test costs is $330—that is, they maintain that 95% of their clients will pay no more than $330 for one of their tests. The reason for the variation in testing costs is that GeneSight collaborates with insurance providers to suppress the costs of testing for most of their users.

However, a possible addition to these costs is the genetic counseling required to order a GeneSight test at a clinician’s recommendation. While health insurance often covers such counseling, if it does not, this advising can cost hundreds or even thousands of dollars.

GeneSight attests that users who are covered by a Medicare or Medicaid plan will pay nothing out of pocket for testing but that those covered by a Medicare Advantage plan will likely have to pay for a portion out of pocket, as will those who have a private insurance plan. Regardless, GeneSight pledges to double-check with its clients who incur over $330 in fees before they bill them for their service.

For those enduring a continuous struggle with poor mental health who’ve been unable to find an effective medication in cooperation with their doctor, GeneSight’s service may offer them a worthwhile solution price-wise.

However, psychotropic testing is very one-dimensional. GeneSight’s test will only inform users about their potential response to medication, not about any other aspects of their health or genetic status. That noted, the full price is fairly high for such a narrow analysis.

Is GeneSight ‘Psychotropic’ testing worth it?

Whether psychotropic testing is legitimately effective at improving doctors’ abilities to prescribe effective treatments has been an ongoing subject of debate in the field of pharmacogenomics.

One persistent issue has been a lack of consistency in the clinical research that has been undertaken so far. Studies in this realm often have a difficult time controlling for factors such as ethnicity. In addition, the potential for pharmacogenomic testing, such as GeneSight’s psychotropic testing, to accurately and consistently predict side effects in patients being treated with particular antidepressant medications has yet to be shown as clinically feasible.

Despite these scientific realities, GeneSight does provide a small selection of clinical, peer-reviewed studies which evidence psychotropic testing as legitimately valuable in the diagnostic process. While the results of most of these studies are statistically significant, they are barely so.

So what’s the straight answer? Essentially, it is still too early to say whether the psychotropic testing GeneSight provides is worth its steep price point. Pharmacogenomics is a field that is still in its infancy and this is reflected in a meek body of clinical research that exists to support its conclusions. At this time, those taking a shot at psychotropic testing are still taking a gamble in an attempt to better their mental health.

Health Recommendations: Applications of GeneSight Testing

As should be evident by now, the only kinds of health recommendations which GeneSight makes are suggestions to your physician about how to treat existing kinds of depressive and mood disorders.

GeneSight does not analyze your genes in order to determine whether you may be at risk for any other type of hereditary diseases, they do not assess how your lifestyle may be affected by your genetic makeup, nor do they give any further wellness guidance whatsoever.

GeneSight is very much a single-minded genetic analysis tool; it is intended to aid doctors diagnostically by reflecting the potential response of a patient to specific medications. For those who are looking to take a more holistic approach to genetic-based health, grasp other ways in which they might improve their daily lives based on their genes, or merely understand their biology at a deeper level, GeneSight isn’t the most valuable resource.

GeneSight Privacy and Security

As a subsidiary of Myriad Genetics, it is Myriad’s privacy policy that governs how GeneSight approaches handling the information of its clients.

The unfortunate reality is that Myriad does collect a selection of their clients’ private information such as names, email addresses, phone numbers, addresses, personal or family health histories, as well as employment and insurance information. On GeneSight’s privacy policy page, Myriad explains that they use this information for marketing and advertising purposes as well as for service improvements.

Myriad also makes clear that they share and disclose some information to third parties. The possible recipients include companies which buy assets from Myriad, as well as vendors, consultants, or other service providers who fulfill tangential roles for Myriad. Myriad does specify that though they choose to share this information with these third parties, those companies are still bound to Myriad’s broader security and privacy policy concerning client information.

Partnerships

As mentioned above, the current CEO of Myriad Genetics is Paul J. Diaz who is also the former president and CEO of Kindred Healthcare—a multi-billion dollar private insurance company that provides rehabilitation services within the United States.

Undoubtedly, Myriad’s close ties to the healthcare industry are part of what has allowed it to provide many of its services at a discounted rate to clients who would otherwise be unable to take advantage of programs such as GeneSight’s psychotropic testing.

While there are no apparent conflicts of interest at play within Myriad’s corporate structure, it is important to bear in mind the monetary incentives of private insurers and the possible dynamic that might create for an executive who moves fluidly between the healthcare industry and Myriad’s upper management.

SelfDecode vs GeneSight

1. SelfDecode offers an expansive array of lifestyle and health recommendations that can help you rethink and improve your lifestyle decisions. Their program is meant to be a truly comprehensive approach to genetics-based wellness. They provide private services for individuals as well as all-inclusive plans for clinicians. GeneSight is more singularly focused on aiding clinicians whose patients are struggling with mental health and doesn’t move beyond that realm of genetics testing.
2. SelfDecode clarifies the scientific justification behind each and everyone one of its health and wellness recommendations so that you understand precisely why each suggestion is being made. GeneSight offers some insight into why it emphasizes gene interactions for certain drugs and not others, but these are exclusively relevant to a patient’s reaction to certain medications.
3. SelfDecode prioritizes its recommendations based on the total analysis of a user’s genetic makeup; the wellness suggestions they provide first are those which are most important to their clients. GeneSight categorizes its diagnostic recommendations based on the significance of gene interaction with certain medications, but these merely serve as additional information for the clinician who makes the final decision about what treatment to pursue.
4. SelfDecode takes an entirely unique, holistic approach to genetic-based health. Their primary aim is to give you a cohesive set of tools and a pool of information with which you can live a superior, biologically sound lifestyle. Of course, GeneSight also wants to help its clients and while they have the potential to help their users tackle a number of persistent depressive and mood disorders, their potential stops there.
5. SelfDecode has a team of over 60 highly skilled scientists, MDs, PhDs, NDs, and software engineers to make sure they deliver the most accurate and science-based health information. GeneSight’s parent company advisory board, Myriad Genetics, is composed of 8 PhDs and MDs.
6. SelfDecode includes a truly expansive test range, studying up to 83 million genetic variants to analyze all of the possible genetic risk factors and hereditary predispositions of its clients. GeneSight investigates 8 Pharmacokinetic Genes and 4 Pharmacodynamic Genes to assess a patient’s potential reaction to medication.
7. SelfDecode backs up all of the information and suggestions it provides to clients with the most advanced and current scientific research available. GeneSight also uses clinical studies to ensure the validity of its product, though as noted above, the statistical significance of such research is still dubious.
8. SelfDecode does not give away or sell your private information to third party entities or other companies. GeneSight, under Myriad’s privacy policy, does share your information with its affiliate companies and also uses its clients’ data for advertising purposes.
9. SelfDecode offer cutting-edge ancestry insights and ancestry-adjusted polygenic risk scores. GeneSight does not offer ancestry analysis.

Comparisons

GeneSight Reviews

Better Business Bureau (BBB)

The BBB reviews of GeneSight’s billing process are a mixed bag. Some users cite satisfaction with their ability to take advantage of GeneSight’s insurance payment options, others voice frustration at absurdly high costs that were apparently incurred after GeneSight billed their insurance company thousands of dollars.

Read what people are saying about GeneSight on Twitter

GeneSight’s hashtag and Twitter account provide news and stories related to the company.

Read what people are saying about GeneSight on Facebook

Comments on the company’s Facebook posts reveal a diverse crowd response to GeneSight’s product.

Alternatives to Genesight

SelfDecode – SelfDecode’s service is for individuals seeking a window into their own biology along with a variety of health, wellness, and lifestyle recommendations, or for professionals looking to improve their ability to assess treatment options. Outside of psychotropic testing, SelfDecode provides quite literally everything else one could want to get out of a genetic analysis.

SelfDecode also offers ancestry insights that include your ancestry composition, mitochondrial ancestry, and other detailed reports (only available with the SelfDecode DNA kit).

Genomind – Genomind provides a similar service to GeneSight with respect to diagnostic guiding tests that are focused on aiding clinicians. They also offer a broader set of psychotropic tests for individuals which includes a general mental health screening as well as an assessment of users’ mental capabilities and predispositions to certain disorders.

Color Genomics – Color Genomics has made attempts to combine more traditional forms of genetic analysis which track hereditary disease with the type of psychotropic testing that GeneSight carries out. They focus many of their efforts on population oriented genetics studies that aim to optimize healthcare and research on a larger scale.

GeneSight Review Summary

Overall, what GeneSight seeks to provide is a novel way for doctors to approach a wicked problem: the often lengthy and difficult process of identifying an appropriate medication for someone struggling with a depressive or mood disorder. This period of trial and error can be extremely challenging for many people battling with poor mental health.

This makes the goals of companies like GeneSight and other pharmacogenomics groups extremely important. All of that being said, the fact remains that this is a scientific area for which very little ground has been tread research-wise. As was noted above, what little clinical research has been carried out has been hindered by inconsistency and statistical insignificance.

For clients who have found success using GeneSight’s service, it is undoubtedly of great value to them. Further, the ability to offset the costs of genetic testing which is made possible by GeneSight’s cooperation with healthcare providers gives individuals who would otherwise be unable to pursue this avenue to treatment another opportunity at getting healthy. For these patients, GeneSight is a good resource.

However, this is a small ingroup when all of the caveats are considered. Genetic research is a vast arena with a huge amount of potential for self-understanding, and frankly, GeneSight is just scratching the surface with psychotropic testing.

For everything else there is to be gained from genetic testing and reporting, SelfDecode is an exhaustive and intuitive service that provides its clients with reports of unmatched clarity and detail. SelfDecode is the only genetic health testing that reveals your likelihood of experiencing specific health issues using cutting-edge ancestry-informed polygenic risk scores.

The variety of their tests and the sheer quantity of the genes which their laboratory examines lets users understand the bigger picture of their genetics, helping them to better not only their mental health but their holistic health and lifestyle beyond. SelfDecode offers personalized health recommendations on mood, stress, and anxiety, three of over 250 health reports available.

SelfDecode also offers cutting-edge ancestry analysis with in-depth ethnicity percentage breakdown, as well as a color-coded map that can help you easily discover where you’re from. You’ll be able to trace your maternal lineage back through the ages, learning where they started in the world, and the journey that they took to get to where you are today.

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