This is the first announcement of this type I have seen. Generation Health bills itself as a genetic benefit management company. It seems interesting that GINA has just become effective with new provisions that prevent family history to be used as it relates back to potential discrimination in hereditary areas and now we have a company wanting to jump in and help patients manage clinical and genetic testing through a pharmacy benefit manager.
From the Website:
“Generation Health is a health management company that specializes in helping employers and other health care payors manage medical costs and improve their employees' and members' health by assuring optimal utilization of genetic testing. Just as pharmacy benefit managers (PBMs) arose in the 1980's to help health care payors better manage their pharmacy expenditures, Generation Health recognizes the need for a genetic testing benefit manager to be a trusted third party that can help payors manage this increasingly complex field.”
As you can see in their statement, this is a focus toward employers and is cost related, so I guess now we can add on genetic testing benefit managers to work with pharmacy benefit managers. It is any surprise that Generation Health was created by two former Medco employees, another large pharmacy benefit manager. You are not going to get a break it appears on any pricing for tests as the article states that clients will be responsible for payment. Pharmacy benefit managers are getting creative and Generation Health appears to be another “business intelligence” company to work with costs with insurance companies for cost, so if we want more genetic testing, here comes the management service to market and negotiate prices. BD
CVS Caremark is expanding its commitment to pharmacogenomics with a new clinical and testing services program being developed in collaboration with newly-formed Generation Health, which describes itself as a genetic benefits management company.
Announced Nov. 10, the program initially is expected to focus on predicting how patients respond to about a dozen drugs in therapeutic areas including oncology, cardiovascular disease and HIV treatment.
Clinical services including genetic testing will be introduced to CVS Caremark's health plan and employer clients in the second quarter of 2010. Services could be used for clinical benefits such as identifying patients who do not respond to certain therapies and thereby avoid disease progression from HIV or prevent cancer recurrence. Clients would pay for the testing.
The companies are also looking at areas in which genetic testing is generally accepted by payers and clinicians - such as testing for warfarin dosing prior to elective surgery - as opposed to routine screening prior to initiating warfarin.
Generation Health has put together a "Best Test" laboratory network to manage testing costs for payers. The firm has also developed data and analytics to review gaps in care among patients, and outreach programs addressing communications between patients, physicians and pharmacists.