Many health benefits leaders are asking questions about the growing field of genetics and genomics in health care. Some companies are asking about the incorporation of genetic testing into health benefits for the purpose of reducing drug costs… this area is often referred to as “pharmacogenomics”. The basic premise is moving to precision or personalized medicine so that the choice of drug and the dose of the drug are specific to an individual’s genetic makeup. Some have been hesitant to move forward with this approach because of the upfront costs of genetic testing or questions related to its value. Will the investment result in a true cost savings?
One perspective may be commonly overlooked when evaluating this option…
Lab tests have always been used as a tool for managing drug therapy…genetic testing is simply another, yet more sophisticated tool.
For example, before implementing drugs such as lithium, potassium, metoclopramide, and many others, a clinician would want to ensure that the patient’s kidneys were functioning appropriately. Now with a once-in-a lifetime genetic test obtained with saliva, a clinician can avoid using drugs in certain patients or customize dosing in others. One test can provide insight into dosing for over 150 drugs. A growing number of studies have shown a reduction in employer costs and improved patient outcomes through pharmacogenomics programs. One study demonstrated a 20% reduction in employer health care costs with a pharmacogenomics program. Another study using a similar program demonstrated a $122 reduction per participant per month for the employer health plan.
Solution
Employers should consider implementing pharmacogenomic testing coverage into their health benefits plan. Educating and empowering members of the value of this test could be beneficial in obtaining greater value of the covered drugs, reducing absenteeism, improving productivity, and improving the health of members on the plan. For some members, this information could impact the OTC products or dietary supplements chosen, as well. The best outcomes will be achieved with ongoing member engagement with a pharmacogenomic specialist to monitor medication changes.