Michigan’s Blue Care Network Piloting Pharmacogenomics Program
Michigan’s Blue Care Network is piloting a precision medicine program, Blue Cross Personalized Medicine, that leverages pharmacogenomics to personalize and tailor medication treatments more effectively for select members based on a review of their prescribed medications for diagnoses including behavioral health, cardiology, cardiovascular and oncology.
The pilot program is running through the end of 2022, with a comprehensive program launch scheduled for January 2023 for eligible Blue Care Network members with pharmacy benefits. The Blue Cross Personalized Medicine program will be provided at no additional cost to members or employer group customers.
The Blue Cross Personalized Medicine program works to optimize the medical benefits of specific therapies for individuals based on their genetics, lifestyle, and environmental factors. Pharmacogenomics is a subgroup of precision medicine that uses an individual’s unique genetic makeup to guide medication treatment options rather than using a “one-drug-fits-all” approach with therapies used to treat an entire population. Blue Care Network has partnered with OneOme, a precision medicine company, to facilitate 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,” said Scott Betzelos, M.D., M.B.A., Blue Care Network chief medical officer and vice president of HMO strategy and affordability, in a statement. “This is a real opportunity to address healthcare 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 guess work and make informed decisions that lead to sustainable treatment options and better patient outcomes.”
OneOme will provide pharmacogenomic testing, reporting and analytics through its evidence-based RightMed for Populations program, which provides population analytics, member engagement, and pharmacogenomic analysis of 27 genes that may affect how a patient would respond to certain medications to reduce adverse drug reactions.
“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,” Betzelos added. “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.”
Each patient and physician will receive a personalized clinical action plan prepared by a trained pharmacogenomic pharmacist who works with their physician to incorporate test results into actionable steps for a targeted plan designed around the patient. Testing results will not be used for underwriting purposes or to deny or increase the cost of coverage, Blue Cross said. Any recommendations for medication or regimen changes are optional and are to be determined and agreed upon between the trained pharmacist, member and their prescribing physician.
In addition to providing more personalized, cost-effective and clinically effective healthcare solutions, this program will also significantly decrease the risk of adverse drug reactions for patients, Blue Cross said. Adverse drug reactions are the fourth leading cause of death, are estimated to cost $136 billion annually and account for up to seven percent of all hospital admissions and up to 20 percent of re-admissions.
