Written by Julie Bick, Ph.D.
Healthcare costs continue to rise year after year, and employers are seeking innovative ways to manage these expenses while maintaining or improving employee health benefits. One emerging strategy is the use of PGx testing to optimize medication use and improve health outcomes. This approach not only benefits employees by tailoring treatments to their genetic profiles but also offers significant cost savings for employers. https://www.managedhealthcareexecutive.com/view/benefits-pharmacogenetic-testing
In this blog we highlight some of the ways that implementing PGx testing can lead to more efficient healthcare spending for employer-sponsored health insurance.
PGx testing analyzes an individual’s genetic makeup to determine how they may respond to certain medications. This information helps healthcare providers prescribe medications that are more likely to be effective and avoid those that could cause adverse reactions. By identifying the most suitable drugs for each patient, PGx testing reduces trial-and-error prescribing, improves treatment outcomes, minimizes unnecessary healthcare expenses and reduces employee absenteeism and presenteeism (Phillips et. al. 2003).
There are many ways in which PGx testing can save an employer money, but probably the most obvious is the significant reduction in adverse drug reactions (ADRs). Many of us don’t even think about ADRs but they are actually a leading cause of hospitalizations and medical complications, resulting in billions of dollars in healthcare costs annually. PGx testing helps identify medications that may pose risks to individual employees and should be avoided, thereby reducing the likelihood of ADRs and their associated costs to both the employer and employee. The list of clinically significant gene-drug interactions that increase the risk of ADRs grows every year, and this risk is increased the more drugs a person is taking. We can further mitigate the risks of severe drug reactions by combining PGx testing with an analysis of the employee’s medication lists and therefore enabling clinicians and pharmacists to proactively adjust prescriptions to minimize risks and ensure compatibility between medications (Gunthrie et. al. 2015).
The benefits of PGx also include the improvement of medication efficacy. Employees receiving ineffective medications often require additional consultations, tests, or alternative treatments. PGx testing ensures that employees start with the most effective medication, decreasing the need for repeated visits and time away from work, and additional prescriptions. In fact, employees who receive effective treatment are more likely to recover quickly and return to work sooner. Reduced employee downtime through lowering absenteeism and presenteeism translates to fewer lost workdays and higher overall productivity, indirectly saving employers significant money.
Another powerful PGx value proposition comes to addressing the cost of managing chronic conditions, which are becoming increasingly prevalent. Chronic conditions like hypertension, diabetes, and mental health disorders often require long-term medications, and therefore optimizing these early on can have significant cost savings (Zhu et. al. 2020). PGx testing can help identify the right medication at the right dose for an individual, thereby reducing complications and long-term healthcare costs.
But by far the most compelling argument for incorporating PGx testing into employee benefits is that there literally is no downside- it’s a win-win. By demonstrating a proactive approach to improving employee health outcomes, employers can negotiate better terms with insurers, and with reduced claims and healthier employees, insurance premiums can be significantly reduced over time (Fagerness et. al. 2014). To this end, the Genetic Information Nondiscrimination Act (GINA) law, passed by congress in 2008 protects employees from biases based on this type of genetic profiling, but enables employers to access aggregate genetic information to negotiate insurance premiums and develop more effective wellness programs for their employees (Mujtaba and Cavico, 2013).
Well first and foremost, partner with a reputable PGx service provider who is CLIA & CAP certified such as Incite Health. Collaborating with a certified PGx testing provider ensures accuracy of the testing and reporting, as well as stringent compliance with health regulations. In addition to lab accreditations, the selected PGx provider should provide clear to read PGx reports, as well as support services such as medication reviews and pharmacist consultations, all of which work to further support employees and ensure their healthcare providers maximize the utility of the individual’s PGx test results.
Partnering with ethically responsible providers such as Incite Health ensures that your employee’s data (including their DNA-profiles) will never be sold to a third party. Incite Health strongly believes that your personal data is yours to keep and share only with whomever you choose. Along the same vein, as an employer offering PGx as a component of your employee’s benefits package, it is critical to provide clear information about the benefits of PGx testing and how it works, and address concerns about genetic privacy upfront and reassure employees about the confidentiality of their results. At the same time, it is important to have the ability to anonymously track the outcomes of PGx testing to measure its impact on healthcare costs and employee health. Any full-service PGx provider such as Incite Health will have access to tools to monitor this and enable the employer to use their employee PGx data to refine the program and demonstrate its value to all stakeholders.
For employees managing multiple- or chronic conditions, who are taking several medications to manage their health, the risk of adverse drug interactions increases significantly. PGx testing can help ensure that prescribed medications are effective and needed to manage the underlying health conditions of that individual, as well as compatible with the other medications and nutritional supplements being taken. This helps to mitigate the risks associated with polypharmacy as well as its costs to the benefit provider. One employee group that polypharmacy affects more than any other are those over 55 years of age. As the workforce ages, the prevalence of chronic conditions and medication use significantly rises. PGx testing offers a proactive way to manage the healthcare needs of older employees, improving their quality of life and reducing hospitalizations and complications.
Another area where PGx has really shown a great deal of benefit is in the treatment of mental health conditions such as depression and anxiety (Serretti et. al. 2011). This is a significant concern given the rise of mental health issues within the working population. In 2019, 15% of working-age adults report mental health struggles, resulting in an estimated 12 billion workdays lost annually from the global economy. Historically, the treatment of these conditions has often involved trial-and-error in finding the right medication. PGx testing can accelerate this process by identifying drugs and doses of these drugs that are most likely to be effective. This can reduce the emotional and financial toll on employees and employers alike (Perlis et. al. 2018; https://www.who.int/news/item/28-09-2022-who-and-ilo-call-for-new-measures-to-tackle-mental-health-issues-at-work).
It is not surprising given these facts that offering PGx testing as part of a health benefits package can set an employer apart in competitive job markets and therefore improve employee retention and recruitment. Employees value innovative benefits that demonstrate a commitment to their well-being, improving retention and attracting top talent (Jarvis et. al. 2022).
A Tech Firm’s Savings
A mid-sized technology company implemented PGx testing as part of its wellness program. Over two years, the company reported a 15% reduction in healthcare claims related to ADRs and improved employee satisfaction with health benefits.
By tracking employees adoption an implementation of PGx testing, particularly those with chronic conditions. The initiative led to a 20% decrease in medication-related issues and significant cost savings on prescription drugs.
Boosting Productivity in a Manufacturing Firm
A manufacturing company with high absenteeism rates introduced PGx testing to address medication-related inefficiencies. Within the first year, absenteeism dropped by 10%, translating into millions in productivity gains.
Improving Employee Health Behavior in a Large US Healthcare System
PGx testing was shown to promote the adoption of healthier lifestyles and health care utilization in its employees (Charnysh et. al. 2024).
As with any new initiative, the cost of implementation is always a consideration. While the initial cost of PGx testing may seem high at ~$350 to $500 per employee, the long-term savings in healthcare expenses and productivity gains often outweigh these costs within a short period of time. Many employers explore options like group discounts or phased rollouts of PGx testing to help de-risk the initial investment.
Collaborating with healthcare providers to integrate PGx testing into treatment plans is an essential component of its adoption. Offering training or informational sessions can help facilitate this partnership, and as PGx testing technology advances, the accessibility and affordability of PGx testing are expected to improve. Employers who adopt this approach early will not only position themselves as leaders in employee wellness but also stand to gain substantial financial advantages.
Mental Health Awareness Month: The role of genetic testing
PGx testing represents an effective tool for employers to enhance employee health while at the same time controlling medical insurance costs. By reducing adverse drug reactions, improving medication efficacy, and supporting overall well-being, PGx testing aligns the interests of employers, employees, and insurers. Investing in this personalized healthcare solution is a forward-thinking strategy that truly benefits everyone involved. Start incorporating PGx testing today for Employee Appreciation Day, and support a smarter way to safer healthcare for all of your employees.
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Guthrie B, Makubate B, Hernandez-Santiago V, Dreischulte T. The rising tide of polypharmacy and drug-drug interactions: population database analysis 1995–2010. BMC Med. 2015;13:74.
Zhu Y, Swanson KM, Rojas RL, Wang Z, St Sauver JL, Visscher SL, Prokop LJ, Bielinski SJ, Wang L, Weinshilboum R, Borah BJ. Systematic review of the evidence on the cost-effectiveness of pharmacogenomics-guided treatment for cardiovascular diseases. Genet Med. 2020 Mar;22(3):475-486. doi: 10.1038/s41436-019-0667-y. Epub 2019 Oct 8. PMID: 31591509; PMCID: PMC7056639.
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Mujtaba, B. G. & Cavico, F. (2013) Corporate Wellness Programs: Implementation Challenges in the Modern American Workplace. https://papers.ssrn.com/abstract=2352353
Serretti, A., Olgiati, P., Bajo, E., Bigelli, M., & De Ronchi, D. (2011). A model to incorporate genetic testing (5-HTTLPR) in pharmacological treatment of major depressive disorders. The World Journal of Biological Psychiatry, 12(7), 501–515. https://doi.org/10.3109/15622975.2011.572998
Perlis RH, Mehta R, Edwards AM, Tiwari A, Imbens GW. Pharmacogenetic testing among patients with mood and anxiety disorders is associated with decreased utilization and cost: A propensity-score matched study. Depress Anxiety. 2018 Oct;35(10):946-952. doi: 10.1002/da.22742. Epub 2018 May 7. PMID: 29734486.
Jarvis JP, Peter AP, Keogh M, Baldasare V, Beanland GM, Wilkerson ZT, Kradel S, Shaman JA. Real-World Impact of a Pharmacogenomics-Enriched Comprehensive Medication Management Program. J Pers Med. 2022 Mar 8;12(3):421. doi: 10.3390/jpm12030421. PMID: 35330421; PMCID: PMC8949247.
Charnysh, E., et. al. Health care utilization and behavior changes after workplace genetic testing at a large US health care system. Genetics in Medicine, Volume 26, Issue 8, 2024, 101160, ISSN 1098-3600, https://doi.org/10.1016/j.gim.2024.101160.
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