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Frequently Asked Questions

General

What is AvertD?

AvertD is a clinically validated, physician-ordered DNA test. It is used to identify an individual’s genetic risk for developing Opioid Use Disorder (OUD), also known as opioid addiction. When use of prescription oral opioids is being considered, AvertD provides an objective way to identify patients who may be at increased genetic risk for opioid addiction. Using this personalized risk information, healthcare providers and their patients can make more informed decisions about how to manage their acute pain (pain lasting <30 days) safely and effectively.

When should AvertD be used?

AvertD is a physician-ordered test intended for use prior to a first prescription of oral opioids for 4 to 30 days to treat acute pain. AvertD test results may provide additional objective information to support more informed decision-making when short-term use of prescription oral opioids is being considered. Clinical settings where oral opioids are prescribed for acute pain include orthopedic surgery, dental procedures, and obstetrics-gynecology surgery.

Because genetics is only one of many known factors associated with increased risk for Opioid Use Disorder (OUD), AvertD test results should be used in conjunction with a complete clinical evaluation to determine the appropriateness of prescription oral opioids for acute pain management.

Who might benefit from AvertD?

Patients scheduled for a procedure where oral opioids may be prescribed to manage acute pain (pain expected to last <30 days) should consider taking the AvertD test. Examples include elective surgeries like a knee or hip replacement, dental procedures like a wisdom tooth removal, or a childbirth-related surgery such as a c-section. Patients and their doctors may benefit from knowing their genetic risk for opioid addiction prior to these procedures to better inform their decisions about how to manage acute pain after.

In addition, patients with a personal or family history of opioid addiction may want to take AvertD to understand if their genetics could be a contributing factor. If the patient is genetically predisposed to addiction, family members of the patient may also benefit from knowing their genetic risk.

How AvertD Works

How does AvertD work?
Using a simple cheek swab sample, AvertD analyzes 15 genetic markers involved in the brain reward pathways associated with addiction to identify if a patient may be at increased risk for Opioid Use Disorder (OUD). The AvertD result report will identify whether the patient has a High Genetic Risk or a Low Genetic Risk. This report will be made available to the ordering healthcare provider via a secure online portal after the cheek swab is received and processed at our CLIA-certified, CAP-accredited lab.
How do I order the AvertD test?

If you are a healthcare provider interested in using AvertD at your practice, please create an account with SOLVD Health at https://portal.avertdtest.com/ and we will ship you a supply of DNA collection kits at no charge to you.

If you are a patient interested in taking the AvertD test, please fill out our Request the Test form at https://avertdtest.com/for-patients/#request_test and we’ll contact your healthcare provider with information about AvertD.

Who collects the DNA sample and how?
The DNA sample is collected via cheek swab by a healthcare professional using our DNA collection kit. The collection kit will include detailed instructions on how to collect, package, and ship the sample back to SOLVD Health at no charge.
How do I send the sample back?
The collection kit will include a return shipping label and detailed instructions on how to collect, package, and ship the sample back to SOLVD Health at no charge.
What is being tested?

AvertD analyzes 15 genetic markers involved in the brain reward pathways associated with addiction to identify if a patient may be at increased risk for Opioid Use Disorder (OUD). A gene is a portion of DNA that determines a certain trait. An allele is a specific form of a gene. Alleles are responsible for the variations in which a given trait can be expressed. Below are the 15 genetic markers analyzed by AvertD.

 

Allele Gene Name rs Number Relative Importance
5-HTR2A Serotonin 2A Receptor rs7997012 100%
ABCB1 ATP Binding Cassette Transporter 1 (ABCB1) rs1045642 73.02%
GAL Galanin rs948854 72.85%
DORA Delta Opioid Receptor rs2236861 46.82%
COMT Catechol-O-Methyltransferase rs4680 36.05%
GABA Gamma-Aminobutyric Acid (GABA) rs211014 32.53%
DRD1 Dopamine D1 Receptor rs4532 30.96%
DAT1 Dopamine Transporter rs6347 29.36%
OPRM1 Mu Opioid Receptor rs1799971 27.72%
DBH Dopamine Beta Hydroxylase rs1611115 26.69%
DRD2 Dopamine D2 Receptor rs1800497 22.57%
MTHFR Methylene Tetrahydrofolate Reductase rs1801133 22.03%
OPRK1 Kappa Opioid Receptor rs1051660 18.09%
DRD4 Dopamine D4 Receptor rs3758653 12.44%
MUOR Mu Opioid Receptor rs9479757 7.21%
How accurate is the test?

AvertD was clinically validated through a blinded, multi-center, longitudinal study evaluating patients after their initial exposure to prescription oral opioids for 4 to 30 days (n=385). They were evaluated at least one year post-exposure. The study design allowed for random representative sampling mirroring adults in the U.S. prescribed oral opioids.

In the study, AvertD demonstrated 82% sensitivity (how often the test indicated High Genetic Risk in patients who developed OUD) and 80% specificity (how often the test indicated Low Genetic Risk in patients who did not develop OUD).1 There were no statistically significant differences in clinical performance observed based on gender, age, length of follow-up from opioid exposure, or ethnicity.

AvertD Test Result

What type of result will I get?

The AvertD result report will identify the patient as having either a High Genetic Risk or Low Genetic Risk. You can view a sample report here.

How soon is the result report ready?

The AvertD result report will be made available to the ordering provider within 3 to 5 business days of the sample being received at our lab, often sooner.

Who gives the test result to the patient?

When the AvertD result report is ready, the ordering healthcare provider will receive an email notification from SOLVD Health. This email notification will prompt them to sign in to SOLVD Health’s secure provider portal to view and print the result report, which they can then share and review with their patient.

What does a High Genetic Risk mean?

Based on the clinical validation study, patients with a High Genetic Risk are 16x more likely to develop Opioid Use Disorder (OUD) than patients with a Low Genetic Risk.1* If a patient is identified as having a High Genetic Risk, the provider and the patient may wish to explore alternative pain management options to minimize or avoid use of opioids. A High Genetic Risk result does not mean you currently have or will develop OUD.

Because genetics is only one of many known factors associated with increased risk for OUD, the AvertD result report should be used in conjunction with a complete clinical evaluation to determine the appropriateness of oral opioids in an acute pain management plan.

To view Clinical Guidance for Selected Common Acute Pain Conditions from the Centers for Disease Control and Prevention (CDC), please visit https://www.cdc.gov/acute-pain/index.html.

What does a Low Genetic Risk mean?

Based on the clinical validation study, patients with a Low Genetic Risk are 16x less likely to develop OUD than patients with a High Genetic Risk. 1* If a patient is identified as having a Low Genetic Risk, existing federal, state, and medical specialty guidelines should still be followed to ensure safe and effective opioid prescribing. A Low Genetic Risk result does not mean you do not currently have OUD or that you will not develop OUD.

Because genetics is only one of many known factors associated with increased risk for OUD, the AvertD result report should be used in conjunction with a complete clinical evaluation to determine the appropriateness of oral opioids in an acute pain management plan.

To view Clinical Guidance for Selected Common Acute Pain Conditions from the Centers for Disease Control and Prevention (CDC), please visit https://www.cdc.gov/acute-pain/index.html.

I’ve received my result. Now what?

You and your healthcare provider will review your result and discuss what your result means for your pain management plan. Together, you will decide what your pain management plan will be. This plan may or may not include prescription oral opioids. If you are prescribed oral opioids, be sure to only take them as prescribed and the least amount necessary. If you have leftover pills, you can learn how to dispose of them properly and safely by visiting https://www.fda.gov/consumers/consumer-updates/where-and-how-dispose-unused-medicines.

Billing & Insurance

How much does AvertD cost?

Our goal is to offer patients the lowest cost option available to them. We are working diligently to ensure AvertD is covered by most insurance companies. Depending on the patient’s insurance, their maximum out-of-pocket cost may vary. If coverage is denied or only part of the test is covered, SOLVD Health may appeal the decision on behalf of the patient. For details about coverage, please contact the patient’s insurance company. If the patient’s insurance does not pay for the test, the patient will be billed directly for $199.

Is this test covered by insurance?

Depending on the patient’s insurance, their maximum out-of-pocket cost may vary. If coverage is denied or only part of the test is covered, SOLVD Health may appeal the decision on behalf of the patient. For details about coverage, please contact the patient’s insurance company. If the patient’s insurance does not pay for the test, the patient will be billed directly for $199.

Who bills for this test (SOLVD Health or the practice)?

SOLVD Health will submit the claim to the patient’s insurance.

Laboratory

Where can I find your lab license numbers, accreditations, and/or certifications?

All lab services are provided by Prescient Lab Services on behalf of SOLVD Health. Prescient Lab Services is located at 1600 Faraday Ave, Ste 200, Carlsbad, CA 92008 and the lab director is Mary Beth Shwayder, MD.

  • CLIA# 05D2051580
  • CAP# 7196892
  • California License: CDF 00343474
  • Pennsylvania Permit: 33739
  • Rhode Island License: LCO01429

Contacting SOLVD Health

Who do I contact if I or my patient have questions?

You can reach our customer service team at 1-760-598-1223 or customerservice@solvdhealth.com.

References

1 Donaldson K, Cardamone D, Genovese M, Garbely J, Demers L. Clinical Performance of a Gene-Based Machine Learning Classifier in Assessing Risk of Developing OUD in Subjects Taking Oral Opioids: A Prospective Observational Study. Ann Clin Lab Sci. 2021 Jul;51(4):451-460. PMID: 34452883.

*Based on an OUD prevalence of 5% in the post-surgical population