Despite the promise of pharmacogenomics and personalized medicine in general, the development and adoption of genetic tests has been relatively slow. Nevertheless, with an interest in both the clinical and economic outcomes, payers are in some ways the ideal gatekeepers for directing the speed and spread of this branch of personalized medicine, particularly for medications that are widely used, risky, or expensive.
Even when it comes to clinical matters, leaders at OSU Health Plan consider it their responsibility to reach out to physicians to keep them involved in the latest developments, says Jim Piper, vice president of business development for the Rx Ohio Collaborative and associate executive director of OSU Health Plan. The cost-benefit equation only pays off if each test is incorporated into a personalized care plan and is adopted into physicians’ daily practice styles. “This information is out there, but I think it’s incumbent upon us in our role to make sure we’re engaging with the doctors,” he says.
Only a handful of tests have so far made it all the way through the adoption process—from the cost-benefit analysis to successful incorporation into daily practice—but the number could grow as the personalized medicine movement picks up steam. In fact, taking the time to analyze individual tests may not be the best approach, and the way forward may come in the form of giant leap instead of a succession of steps.
Instead of assessing each test on a case-by-case basis, OSU is discussing covering the entire genetic panel, says Lehman. That’s how many in healthcare envision the future of personalized medicine—a patient’s entire genetic information will be incorporated into his or her health record and used throughout life to improve treatment and predict disease occurrences. It would be more clinically effective, and might be more economical as well. “It would be much less expensive to look at whole genetic panel of individual,” he says.