Fully Realized PharmacoGenetics (PGx) for Clinical Practice

Problem. PharmacoGenetics (PGx) is a form of personalized medicine, a decade-old diagnostic technology that provides insight into how an individual’s genetic attributes affect that patient’s likely response to therapeutic drugs. That said, it remains largely unused by the medical community, meaning that many patients are prescribed medications that their bodies cannot use, and sometimes patients receive drugs that cause an adverse medical event. The problem is not that PGx doesn’t work well, but that it has not been integrated into the US health system’s clinical workflow.

FULL REALIZED
PHARMACOGENETICS FOR
CLINICAL PRACTICE

Solution. This laboratory organization, like many labs around the US, performs PGx testing with genomic reporting that can be accessed by patients, clinicians, health plans, PBMs and other players in the care continuum. But BG has developed a patented capacity to make the test results and their implications immediately available to all players as well. The information is embedded into the EHR and, if a clinician prescribes a medication that the patient cannot metabolize, he/she will receive an alert through the EHR saying that the patient cannot benefit from that script, along with suggestions of other drugs that are more likely to be helpful. The patient will receive a smartphone notification. The PBM and the health plan will receive the information also.

Results. A large sample size study released in March, 2022 showed that a PGx-enriched health plan of 5,288 Medicare Advantage (MA) members spent approximately $7,000 per member than a comparable group of 22,357 seniors whose care did not include PGx. That translates to an annual savings of $2,625 per MA member per year. Considered another way, if all 65,103,807 (in 9/22) Medicare beneficiaries had the benefit of PGx-informed care, the program should generate $170.9 billion in annual savings.

This technology promises to get widespread adoption. United Health Group has agreed to make this organization’s PGx testing and reporting functions available to its employees and their families. Pilots are underway with Blue Cross of Texas, the brokerage Hub Group, and other large groups. The resulting aggregate pilot data should constitute the largest PGx sample that has been available to date, which should shed light on how PGx will change the utilization dynamics of the US Pharmacopeia.

Market Differentiator.

  • This company’s unique technology makes PGx immediately available and useful within the clinical workflow, facilitating significant health outcomes and cost impacts that have been unavailable until now.

Target Markets.

  • Healthcare provider organizations, especially those carrying risk for health outcomes and cost.
  • Healthcare purchasers, health plans, PBMs, stop-loss carriers, captives, and primary care organizations that carry risk.

Do you think your organization is truly high-performing?

Schedule a free evaluation call to find out and learn how Proven Health can help you leave your competitors behind. 

Our Process:
1. We will contact you within two business days to send you a mutual non-disclosure agreement (NDA) for signature.

2. Once the NDA is signed, we will request your marketing materials, with an eye toward understanding:
• The problem(s) you solve in the healthcare market.
• Your solution.
• How your approach is different.
• Your target markets.

3. When we receive this information, we will schedule a one-hour free consultation to learn about your effort in more depth, and to talk through how Proven Health can help you achieve your goals.