New Pharmacy Practice Data Have Been Reported by Investigators at Notre Dame of Maryland University (Coverage of pharmacogenetic tests by private health insurance companies)

2020 MAY 08 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators discuss new findings in Drugs and Therapies - Pharmacy Practice. According to news reporting from Baltimore, Maryland, by NewsRx journalists, research stated, “To assess the coverage of clinically relevant pharmacogenetic tests by the top 41 private insurance companies in the United States. Websites of insurance companies were searched for medical policies addressing 34 common and clinically relevant pharmacogenetic tests referenced by the Clinical Pharmacogenetics Implementation Consortium, PharmGKB, and Food and Drug Administration product labeling.”

The news correspondents obtained a quote from the research from the Notre Dame of Maryland University, “Those policies were subsequently reviewed for the coverage of the tests by gene-drug pair and by company. Policies were subsequently reviewed to determine coverage of pharmacogenetic tests by gene-drug indication group (GDIG) and an insurance company. Settings and participants: Not applicable. Within unique policy sets, the following were analyzed: (1) the number of times each GDIG was mentioned; (2) the percentage of times each GDIG was mentioned; (3) when mentioned, the number of times each GDIG was covered; (4) when mentioned, the percentage of times each GDIG was covered; and (5) regardless of being mentioned, the percentage of times each GDIG was covered. A total of 223 medical policies mentioning pharmacogenetic tests were retrieved, representing 34 unique policy sets from 41 companies. Thirty-three companies had their policies accessible on their website. Approximately 50% of GDIGs were unanimously mentioned in all policies but were covered only < 20% of the time. When mentioned in a policy, 7 GDIGs were uniformly covered, and 11 GDIGs were uniformly not covered. Overall, insurance companies covered approximately 40% of GDIGs mentioned in their policies. The medical policies addressing recommended pharmacogenetic tests were not readily accessible on websites of the top private health insurance companies.”

According to the news reporters, the research concluded: “The coverage and payments of the tests varied by the company and gene-drug pairs and remain suboptimal.”

For more information on this research see: Coverage of pharmacogenetic tests by private health insurance companies. Journal of the American Pharmacists Association, 2020;60(2):352-+. Journal of the American Pharmacists Association can be contacted at: Elsevier, Radarweg 29, 1043 Nx Amsterdam, Netherlands.

Our news journalists report that additional information may be obtained by contacting S.K. Park, Notre Dame of Maryland University, School of Pharmacy, Dept Clin & Adm Sci, 4701 North Charles St, Baltimore, MD 21210, United States. Additional authors for this research include J. Thigpen and I.J. Lee.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.japh.2019.10.003. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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