Enterprise PMM in Action
Teachers’ Group Retirement Plan
This state-run pension program covers approximately 33,000 retired teachers, ranging in age from 62 to 107. At 65, their members take an average of 15 prescription medications per year—in addition to over-the-counter medicines, vitamins and supplements. That’s a lot of copays and a lot of potential for side effects, adverse drug reactions, drug-drug interactions, and drug-gene interactions.
This group retirement plan was looking for an innovative solution to simultaneously lower healthcare costs while improving the health and satisfaction of members. In April 2017, they turned to Coriell Life Sciences.
As part of the turnkey, DNA-based medication management program, they began with a population risk assessment. Using the group’s claims data and Coriell Life Sciences – Comprehensive Health Insight Portal (CHIP), they found that almost 84% of members were on at least one drug known to be affected by genetics. Immediately, the group learned that 23,000 of their 33,000 members needed to stop or change at least one medication. This gave the plan administrators a sense of how much they could save by leveraging PMM and which cohort of members would be most likely to benefit from PGx testing.
The first step was reaching out to these high-risk members, inviting them to be tested as part of a free service offered by the retirement plan. The turnkey PMM program handles everything, including invitations and enrollment. Members who agree to participate are sent a saliva collection kit that they then ship to one of our network of laboratories for DNA analysis.
For each member, a simple ducal swab one-time DNA analysis is performed through CLS interpretative algorithms to generate a detailed and personalized medicine report. This report includes pharmacogenomic alerts as well as known drug-drug interactions, lifestyle factors, age-related toxicity risks, FDA black box warnings, and medication risks associated with cognitive impairment. The interactive report is then subjected to pharmacist review to develop a recommended Medication Action Plan (MAP) shared with the member and their primary care physician.
Throughout the program, a dashboard allows the plan administrators to monitor overall member enrollment and progress through the system. The administrators receive general financial and plan statistics, while members’ individual health privacy is maintained.
Results Thus Far
- 56% of members tested received immediate medication change recommendations
- 32% were told they have genetic issues with statins
- 46% were alerted not to take Metoprolol
- 28% were found to be non-responders to Plavix
Reactions From Members
- “The test identified two problematic issues in my gene structure.”
- “It’s nice to see TRS participating in new and more exciting things.”
- “This is what health care should be.”
The one-time DNA analysis continues to serve the members long-term. As they are prescribed other drugs, they can consult with the plan’s pharmacy board to ensure the drug is right for them.