Measuring Utilization, Expenditures for Drugs With Pharmacogenomics Prescribing Guidance

Researchers recently examined the prevalence of evidence-based, pharmacogenomically guided medication use across different payer types in Minnesota and observed increased usage trends, as well as increasingly faster adoption.

Hannah Berg, fourth-year student pharmacist at the University of Minnesota, and Joel Farley, PhD, explained in a poster presentation at AMCP 2021 that the use of this medication is expanding with the adoption of clinical practice guidelines by groups such as the Clinical Pharmacogenetics Implementation Consortium (CPIC).

“CPIC assigns Level A ratings to gene/drug pairs with the clearest evidence of benefit and risk, explained the researchers. “These severity ratings reflect differences in metabolism, treatment failure, or life-threatening events”

Using public data from the Minnesota All Payers Claims Database the researchers measured the prevalence of CPIC Level A drug utilization across different payer types in Minnesota from 2012 to 2016. They then categorized claims into commercially insured, state funded (Medicaid), and Medicare populations. Prescription utilization and expenditures were captured via descriptive statistics and compared payer to payer.

According to the data, $2.4 million worth of CPIC Level A prescriptions were dispensed in 2016. A 37.8% decrease in CPIC Level A utilization was observed for commercial health plans compared with 15.6% and 10.6% increases in both Medicaid and Medicare, respectively. These increases in utilization were slower than enrollment rates for both Medicaid and Medicare during the same period.

Expenditures reduced 54.4% for commercial plans and increased for Medicaid (+3.3%) and Medicare (17.1%).

“Although the utilization of Level A drugs differed between payers, commonly prescribed medications across insurers included statin medications, oxycodone, and citalopram,” explained Ms Berg and Dr Farley. “The ranking of these commonly prescribed drugs changed little between 2012 and 2016.”

Overall, the researchers confirmed that exposure to medications with pharmacogenomic guidance is growing increasingly common across payer types in Minnesota.

“This trend implies a significant opportunity to adopt greater pharmacogenomics testing to improve the benefit of medications in patients and reduce potential risks,” concluded researchers. “Given the significance of prescribing in Medicare and Medicaid, national coverage of pharmacogenomics testing may be beneficial.”

—Edan Stanley

Reference:
Berg H, Farley J. Medication utilization and expenditures for drugs with pharmacogenomics prescribing guidance: evidence from the Minnesota All Payers Claims Database. Poster presented at: AMCP 2021, April 12-16, 2021; Virtual