Photo illustration of DNA in a test tube

The Role of Pharmacogenomics Testing in Prescribing Medications

Typically, doctors prescribe drugs based on factors including a patient’s age, weight, sex; and liver and kidney function. For some drugs, researchers have discovered that genetic markers may influence treatment response. In those cases, pharmacogenomics testing can be used to determine the right drug and dose for a patient.

WHEN PHARMACOGENOMICS TESTING IS USED

Did you know your genetics can play a role in how you respond to certain medications? For example, your body may break down a medication too slowly or too quickly, which could result in unintended side effects, or no therapeutic effect at all. While each person is unique in how their body processes medications, you can help health care providers find the medication that may work best for you with pharmacogenomics testing.

PHARMACOGENOMICS TESTING AND BLUE CROSS COVERAGE

As announced in April 2022, Blue Care Network will be working with OneOme® to facilitate Michigan’s first end-to-end precision medicine pharmocogenomics program – Blue Cross Personalized Medicine. A pilot program is currently underway for select members through the end of this year, and a comprehensive program launch is scheduled for January 2023 for eligible Blue Care Network members. Using OneOme’s RightMed® Test, providers will be able to use a patient’s genetic test results to help find the right medication for them. This can be used in various diagnoses including behavioral health, cardiovascular disease and oncology.

Blue Cross Personalized Medicine will be available for eligible Blue Care Network members with pharmacy benefits. Having both medical and pharmacy coverage through the same plan ensures the most efficient care coordination, since medication and claim reviews confirm each prescription is the appropriate treatment for the patient’s specific needs.

The Blue Cross Personalized Medicine program will be provided at no additional cost to eligible members or employer group customers. Blue Cross Blue Shield of Michigan and Blue Care Network are not involved in the process and do not have access to the test results, and the results will not affect a member’s coverage. Any recommendations for changes based on the results are optional and will be determined and agreed upon by the trained pharmacist, the member and their physician.

The future of pharmacogenomics testing is promising as precision medicine that aims to treat each patient individually becomes more common. As the medical field continues to produce drugs that are more complex and more specific, the need for genetic testing will continue to grow. Tailored drugs could be available in the future to treat heart disease, Alzheimer’s disease, HIV/AIDS and asthma.

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