Case Study
Improving Patient Outcomes with Pharmacogenomics
Pharmacogenomics (PGx) combines pharmacology and genomics to study how a person’s genetics affect their response to medications. Despite advancements in healthcare, medication selection often remains a trial-and-error process. For example, in mental health, first-line treatment failure can be as high as 70%.
By using PGx testing, providers can prescribe medications more effectively, improving outcomes and reducing the risk of serious side effects, a major cause of ER visits and hospitalizations. This also leads to significant savings for employer health plans.
By leveraging the power of pharmacogenomics, Tria Health’s program has been able to provide our clients with improved health outcomes and cost savings.
Targeted Outreach to High-Risk
Tria Health recognizes the importance of managing costs effectively, which is why we offer PGx testing specifically to high-risk individuals engaged in our Pharmacy Advocate (PA) program. With an already impressive engagement rate of 35%, integrating PGx testing into the program was seamless. We evaluate PGx-implicated medications in use, and assign each individual a score to assess the relevance and value of PGx testing.
The genetic test is a simple cheek swab mailed to the patient. Once returned and the test is processed, our pharmacists review the report with the patient and provide direct outreach to their physicians. Given the complexity of the genetic report, this personalized care is crucial to ensuring that both patients and their physicians fully understand the results and their impact on the current and future medication regimens.
Delivering a 1.6:1 Return on Investment
The results of incorporating Tria Health's pharmacogenomics program with the client were
highly successful. High-risk members were successfully identified and targeted, and adverse drug events were identified.
Adverse drug events (ADEs) refer to the adverse reactions that may occur due to genetic variations in drug metabolism or drug response.
Furthermore, the client was able to achieve a 1.6:1 return on investment, with the cost of the testing being offset by the savings from avoiding adverse drug events. Overall, the pharmacogenomics testing was a beneficial addition to the client's healthcare benefits offering.
Current PA Engaged (35% Engagement Rate): | 895 |
PA Engaged & PGx Eligible: | 51% |
PGx Engaged: | 34% |
Adverse drug events avoided per consult (valued at $589 per ADE): | 5.2 |
Return on Investment
1.6:1
Patient Success Story -
Just the Right Statin for Reducing Cardiovascular Risk
This patient had been struggling with statin therapy for years, experiencing severe side effects such as myalgias (muscle pain). Her healthcare providers were unable to explain why she was so prone to statin side effects. As a result, she was not taking any medications to treat her cholesterol, putting her at serious risk for complications. Tria recommended PGx testing for this patient.
Fortunately, the PGx results revealed a genetic variation affecting SLC01B1, which is involved in statin metabolism. Her test results revealed that among the several statins available in market, only one can be metabolized by her body. Her Tria Health pharmacist was able to work with her physician to get a prescription for the exact right medication. After starting this new therapy, the patient reported that she had no side effects and was able to reduce her cardiovascular risk.
Client Overview
This Tria Health client is a government plan with more than 7,000 members. They had been considering offering PGx for a few years, but were concerned about cost.
Tria’s ability to target high risk members made it possible for them to offer this program. The average patient participating in Tria's Personalized Medicine Program has a lot to manage.
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Age: 54
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Medications: 14.5
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Chronic Conditions: 3.4
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Total Conditions: 10.1
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Physicians: 3.3
References
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J Am Pharm Assoc (2003) 2020 May-Jun;60(3):462-469.e4. doi: 10.1016/j.japh.2019.12.004.Epub 2020 Jan 13.