I've had more than one provider tell me that older people are often more sensitive to warfarin, and their risk for bleeds is increased due to their age. I've been as high as 6.2 I think, and me at 6.2 vs an elderly person at 6.2 seems to me to be a very different scenario. For me, I was given vitamin K tablets. My friend's mom is in her 70s and has a hard time staying on top of her warfarin (she's in the early stages of dementia) and she has been hospitalized with an INR just over 4 for her own safety. I can totally see how this testing would be beneficial for someone at high risk for sure.

Jeb, let us know how that test shakes out for your mom. I think it's really interesting that they can even test for that.

rmb said---- correctly:
"Right, the original post was about DNA testing to see how your body processes warfarin, not the genetic testing to see if you have a clotting disorder. Two completely different things, at least that's what I'm understanding."

If everyone had had full genetic profiles done BEFORE even knowing what the heck a PE was then they would be forewarned/forearmed. Do I think that those people should be started on warfarin after getting genetic testing, if the profile showed a glitch in the genes that might lead to a PE?

Absolutely not!

BUT as soon as they were dx'd with a DVT or PE then they could have been put on the 'correct' dose of warfarin immediately. That would lessen time in the ICU, maybe. Certainly lessen the time for the trial and error way now.

Yes, the cost is fairly high----- but I wonder if a genetic test for less money can be done for only the two genes (CYP2C9 and VKORC1) if a person had a family member who had had a PE. That shows how little I know about the tests and maybe it's just wishful thinking---- but wouldn't it be loverly?

The price for full genetic testing is going down but it's still expensive. Earlier I had researched it but don't have the prices at 'full recall'. :) And I'm sure that most insurance companies won't pay for it. (Mine did a decade ago but it was still in it's 'infancy' and probably not as good or as complete as the ones now, I don't know. Even now most doctors wouldn't know what to do with a genetic test!)

Pharmcogenetics SHOULD be in our future, I believe. But there are many reasons for it to become an uphill battle -special interest groups (there's always someone against progress)- ethicists, funding, yada yada.

I'm hoping for the day when all newborns have a genetic profile done routinely. I'm not talking about genetic 'screening' which is already done for most newborns---- according to state. Having genetic screening for some serious diseases is a good idea. But there are still 'worries' by some people.

http://kidshealth.org/parent/system/medical/newborn_screening_tests.html#

Wiki's 'controversy' page explains a few things:
http://en.wikipedia.org/wiki/Newborn_screening#Controversies

I haven't had a chance to discuss the following article with a genetic counselor I'm friends with to gather their insight on how this will affect our patient community and other communities:

http://www.forbes.com/sites/scottgottlieb/2013/03/27/medicare-has-stopped-paying-bills-for-medical-diagnostic-tests-patients-will-feel-the-effects/?partner=yahootix

"Diagnostic tests were supposed to usher in an age of personalized medicine. Now theyre being actively priced controlled. And by a bureaucratic regime that cant even figure out what prices they want to pay for these services."

Why am I not surprised! LOL

Gottleib also said"

"The agencys skeleton coverage team of 20 physicians and its lack of scientific rigor means decisions turn mostly on cost."

http://www.aei.org/article/health/medical-technology/fda/washington-health-agencies-are-practicing-medicine-the-case-of-a-sick-heart/

And while Medicare is burrowing and doing it's nasties, CatalyzePaymentReform.org is showing us how poor transparency for health care pricing is in the States.

" Nearly 30 states get "F" grade for healthcare price transparency laws. A March report showed the comprehensive lack of public policy and state legislation for pricing transparency"

http://catalyzepaymentreform.org/images/documents/reportcard.pdf
(Page Four, near the top)