Michigan’s Blue Cross Blue Shield offers DNA tests for more accurate prescriptions

Michigan’s Blue Cross Blue Shield offers DNA tests for more accurate prescriptions

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For some Blue Cross Blue Shield members in Michigan, the days of trial and error for new drugs are over.

The Detroit-based insurer last month launched a precision medicine pilot program for 500 Medicare Advantage patients that uses pharmacogenomics, or genetic testing, to determine which drugs will be successful based on genetic predispositions.

The program provides patients with self-administered swab tests, and their doctors use the results to determine which medications are appropriate for a variety of common diagnoses, including depression, high blood pressure and more. Results will be delivered within three to three minutes to patients and their physicians who will provide testing and analysis, said Julie Hessik, senior director of business development at OneOme, a third-party provider of testing and analysis, who took part in the five-day test.

“What this opportunity offers us is to provide physicians with the most effective medicines,” said Scott Betzelos, chief medical officer at Blue Care Network and vice president of HMO strategy and affordability at Blues. “The value is in reducing complications that can occur. Once you have PGX (pharmacogenomics) testing, you can ease the trial-and-error approach to prescribing medication. Your DNA never changes, so testing works with you to balance your life.”

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BCBSM will not know the genetic test results, and the test results will not be used for coverage purposes or to deny or increase the cost of covering Betzelos.

The test is free for current patients in the pilot program and will be expanded to more patients in January 2023. It’s unclear how many people will be involved in the full rollout of the program.

For Bruce, the program has an opportunity to eliminate costly complications from prescription drugs and therapies, as well as eliminate additional prescriptions for drugs that are ineffective against a patient’s DNA.

“The program has value in terms of patient responsiveness, reducing complications and reducing emergency room visits,” Betzelos said. “Patients also don’t have to take multiple medications to find the right one.”

Adverse drug reactions are the fourth leading cause of death in the United States, costing an estimated $136 billion annually, according to BCBSM. Adverse reactions also accounted for approximately 7% of all hospital admissions.

This story first appeared in our sister publication, Crain’s Detroit Operations.

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