According to the Kaiser Family Foundation, prescription drugs represent 10 percent of all health spending.1 While this is predicted to hold steady for the foreseeable future, self-insured employers remain laser-focused on managing pharmacy costs. And rightfully so.

If we set aside specialty pharmacy for the moment, traditional prescription drugs promise and deliver significant value, dollar for dollar, in treating the ailments they are designed to treat. Yet, often, finding a drug that balances efficacy against side effects can be tricky. Ask any person who’s tried and failed multiple antidepressants. They will tell you it can feel like an endless chase to find the medication that helps them feel better in one way without feeling worse in some other way.

The costs of prescription drugs, beyond the medication itself

When an employee is prescribed a new medication, you, as a self-insured employer, expect to incur a cost for the medication. Less expected, however, are the additional costs that could result, including the multiple prescriptions the employee may need to try before the right medication and dose is identified, or any costs associated with treating side effects or adverse drug reactions (ADRs) caused by the new medication(s).

These additional costs—especially frustrating when driven by generics and less expensive brands —are not uncommon. In fact, according to one popular study, response rates for many medications are only between 50-75%,2 meaning that up to half of the medications prescribed may not work like they’re intended to. This can result in doctors using a trial and error method to find the right prescription for the employee — increasing or decreasing the dose, trying an entirely new medication, adjusting that dose, and so on. For employees, this process can feel endless as their condition goes untreated, or worse, as they feel sick from the medication’s side effects. For your organization, this process can be expensive.

What’s more, if the medication causes an adverse drug reaction (which happens to be the 4th leading cause of death in the United States3) and the employee needs to be hospitalized for it, a two-fold greater mean length of stay, cost, and mortality could occur.3 Now, in addition to the cost of the medications, you are also incurring the cost of the hospital expenses. This begs the question: Is there a way to get people to the right medications quicker and for less money?

Genetic testing to help identify the right medication for employees

Fortunately, a type of genetic testing has emerged that may help identify which medication is right for an employee — before they start taking it. It’s called medication response testing, and it’s based on the science of how our genes affect our response to medications (also called pharmacogenomics).

Given that our genetic makeup is responsible for up to 95% of how we respond to medications,4 a medication response test can provide doctors with powerful insights into how an employee is likely to respond to hundreds of medications. Doctors can use these insights when choosing which medication and dose to prescribe an employee, which could lead to more effective medications with fewer side effects and adverse drug reactions.

Medication response testing used to avoid adverse drug reactions

A practical example of the power of medication response testing is with the medication clopidogrel, a commonly prescribed antiplatelet blood thinner. Thirty percent of the U.S. population cannot properly process clopidogrel, and as a result, may not receive the very benefit the medication is intended to provide.

If an employee is about to undergo surgery and may be prescribed clopidogrel, a medication response test would be a valuable resource to determine whether the medication is likely to be effective for the employee or whether it may cause dangerous adverse events. If the employee’s doctors know in advance to choose an alternative to clopidogrel, an adverse drug reaction could be avoided altogether.

This is just one example of many. OneOme’s RightMed test covers over 350 medications used to treat 30 medical conditions, including depression, anxiety, cardiovascular disease, cancer, chronic pain, and more. The potential uses of the RightMed test are vast.

How to offer medication response testing to employees

Employers are beginning to see the benefits of offering medication response testing to their employees. Beyond the potential to lower employee healthcare costs by helping employees get on the right medication quicker, medication response testing is also helping to set employers apart in attracting and retaining talent in this competitive hiring market.

If you’re looking for a good place to start with medication response testing, here are some good options:

  1. Sponsor it: Offer a medication response test at a discounted rate for those employees who are curious about their DNA and how it affects their response to medications.
  2. Feature it: Create a health and wellness program around it. Whether it’s adding medication response testing to your annual health and wellness promotions, or launching an internal wellness campaign around it — build awareness of medication response testing and its benefits to employees.
  3. Focus on it: Implement programs for certain medical conditions, like depression, or offer it to your employees who take several (usually about five or more) medications. By offering the testing to the employees who need it the most, you can also assess how it impacts your bottom line.
  4. Cover it: Add it to your benefits plan. Educate employees on medication response testing and back it up by offering it as a covered benefit.

If you’re interested in exploring one of the above scenarios for your employee population, please contact me at markbillmayer@oneome.com. We can set up an exploratory call to discuss your company’s unique situation and consider what would work best for you.

Questions? Comment below or shoot me an email.

Mark Billmayer
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