Michigan Blue Launches Pharmacogenomics Precision Medicine Program

Blue Care Network recently announced the launch of Michigan’s first end-to-end pharmacogenomics precision medicine program, Blue Cross Personalized Medicine. This program leverages genetic testing to tailor drug treatments to certain individuals upon review of prescribed medications for various behavioral health, cardiology, and oncology conditions.

For select members, a pilot program will run through the end of 2022, while a comprehensive program launch is scheduled for January 2023 for eligible Blue Care Network members with pharmacy benefits. The Blue Cross Personalized Medicine program will be offered to members or employer group customers at no additional cost.

Precision medicine technology is used in the healthcare industry to assist in tailoring treatments and medications to an individual. Pharmacogenomics — the study of how an individual’s genes affect how they respond to medication treatments — helps decide a course of treatment. Pharmacogenomics account for a person’s distinct genetic makeup, lifestyle, and environmental factors.

Blue Care Network and OneOme, a precision medicine company, have teamed up to develop the new program.

“Our first priority with the Blue Cross Personalized Medicine program is to ensure that a physician is able to provide the right medication, at the right dose, as early in the process as possible,” stated Dr. Scott Betzelos, Blue Care Network chief medical officer and vice president of HMO strategy and affordability.

“This is a real opportunity to address health care on a person-by-person basis that is tailored to each member’s individual needs. Working closely with our members and their physicians, we are now able to cut out the guesswork and make informed decisions that lead to sustainable treatment options and better patient outcomes,” Betzelos continued.

Pharmacogenomic testing will be provided by OneOme. The resulting data will be submitted through its evidence-based RightMed for Populations program, which delivers member engagement, population analytics, and pharmacogenomic analysis of 27 genes that could affect how a patient might respond to certain medications.

Over 90% of patients have genetic variants that could affect their responsiveness to medication, according to a Mayo Clinic study. Pharmacogenomic results help healthcare providers assess drugs across multiple fields such as behavioral health, oncology, pain management, and cardiology.

“Our Blue Cross Personalized Medicine team has worked diligently to develop an exclusive end-to-end experience for our members. Patients will manage their own DNA sample collection, using OneOme’s easy-to-follow at-home kit, which is then mailed directly to the OneOme laboratory where results are processed and then shared only with the patient, their physician and supporting pharmacist provided by OneOme. Blue Cross, Blue Care Network and our members’ employers are not involved in the test collection or analysis process and are not provided access to the test results at any time,” Betzelos said in the recent announcement.

Every patient and physician will receive a personalized clinical action plan arranged by a trained pharmacogenomic pharmacist who works closely with the physician to transform test results into actionable steps for a targeted patient-centered healthcare plan.

“We understand and respect the sensitivity that people have when it comes to protecting their genetic information, and we have built robust protections into our program,” said Betzelos.

Genetic testing results will not be used to increase or deny the cost of coverage or for underwriting purposes. All recommendations for medicinal regimen changes are optional and must be determined and finalized by the authorized pharmacist, patient, and their prescribing physician.

This program will provide more personalized, cost-effective, and clinically effective healthcare solutions and decrease the risk of adverse drug reactions considerably.

As the 4th leading cause of death, adverse drug reactions cost around $30­–136 billion a year in the United States and account for up to 7% and 20% of all hospital admissions and re-admissions, respectively.