Pharmacogenetic Testing

In this article, we discuss how pharmacogenetic testing may be poised to help plan sponsors reduce costs while simultaneously helping employees finding the right treatment faster.

Pharmacogenetic testing (PGx) assesses how an individual metabolizes a drug based on variations in their genes. In this way, it can help identify which medication is the most compatible on the first try and reduce side effects.

There have been significant advances in the area of pharmacogenetic testing, and this is great news for plan members and plan sponsors alike. Some industry experts say that it may have the potential to revolutionize prescription drug use in Canada by tailoring treatment to individual patients and save public and private payors billions in healthcare spending.

These tests range from $300 to $1,500 and are not covered by public health plans. They can be purchased online, at community pharmacies and sometimes through workplace benefits plans.

How effective is Pharmacogenetic Testing?

Manulife is conducting an ongoing study which has found that 80% of members changed their medications as a result of the test, and 86% reported an improvement of their mental health. When you combine these positive outcomes with data from Telus Health, you can see the potential impact.

Telus Health finds that 1 in 4 workers takes medication for a mental health issue, and for over half of those plan members, the first prescription was not effective. In fact, it took more than a year for 32% of people to find the right medication.

Barriers to Uptake

Canada’s Genetic Non-Discrimination Act, passed in 2017, may have inadvertently swept pharmacogenetic testing into legislation that prohibits any person or organization from requiring someone to undergo a genetic test for the prediction of disease or vertical transmission risks, diagnosis, or prognosis. While PGx testing focuses on drug compatibility, it is not exempt from the legislation.

If the pharmacogenetic testing is embedded in a benefits plan, employees may question whether the results of the testing are shared with the plan sponsor (they are not).

Despite these hurdles we’re hopeful that there will be further advancement in this area and that we’ll see reduced time away due to disabilities, reduced frustration for plan members trying to improve their health, and reduced costs for plan sponsors from disability claim costs.