Blue Care Network in Detroit is launching a precision medicine program called Blue Cross Personalized Medicine that leverages pharmacogenomics — or genetic testing — to personalize and tailor medication treatments more effectively.
The program is for select members based on a review of their prescribed medications for various diagnoses including behavioral health, cardiology, cardiovascular, and oncology.
A pilot program is underway for select members 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.
“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,” says Dr. Scott Betzelos, chief medical officer and vice president of HMO strategy and affordability at Blue Care Network.
“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 guess work and make informed decisions that lead to sustainable treatment options and better patient outcomes.”
Precision medicine, or personalized medicine, recognizes that certain drug therapies succeed or fail based on the genetic predisposition of the patient. 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.
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.
In a Mayo Clinic study, more than 90 percent of patients were found to have genetic variants that could affect their responsiveness to a medication. Providers can use pharmacogenomic results to help evaluate medications across multiple specialties including behavioral health, oncology, pain management and cardiology, among others.
“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. Our Blue Cross Personalized Medicine team has worked diligently to develop an exclusive end-to-end experience for our members,” says Betzelos.
“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 health care plan designed around the patient. Testing results will not be used for underwriting purposes or to deny or increase the cost of coverage. 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.
