RBC Insurance is taking a two-pronged approach to helping its group benefits clients suffering from autoimmune illnesses by implementing pharmacogenetics testing – looking at how genes affect a person’s response to drugs.

“There’s a lot of great research that shows the drug-gene interaction and how genetic factors can lead to a person’s response to a given medication,” said Julie Gaudry, senior director of group insurance at RBC Insurance.

Preferred pricing

Historically, pharmacogenetics testing via a drug compatibility test has been expensive, said Gaudry. But RBC Insurance is offering preferred pricing to all of its clients to test for drug compatibility. Gaudry said the test is typically $499, but it is offering the test now for $299.

Using a cheek swab, a drug compatibility test checks for the presence of genetic markers to help predict what medications are the safest to prescribe for an individual.

But there hasn’t been that much research into whether the testing will cause people to change to a different medication or how that will affect their recovery in either the public or private health care systems, she said.

Testing is available for traditional drugs used for treating a number of chronic diseases, including rheumatoid arthritis, cardiac conditions and mental health. Currently, there are about 200,000 adverse drug reactions every year costing the health care system more than $13 billion every year. On top of that, the effectiveness rate for many common drugs is less than 60%.

Gaudry said the test will examine more than 900 brands of medications aimed at a number of physical ailments.

RBC Insurance is also partnering with Personalized Prescribing Inc. to offer a program aimed at identifying a test to evaluate the role genes play in determining a patient’s response to autoimmune biologic drug therapy. The study is expected to take place over a year and will be free to group benefits clients.

Biologics can be expensive and are a major driver of drug costs, but Gaudry said there is currently no pharmacogenetic test readily available for biologics and autoimmune illnesses.

RBC said this clinical study is the first of its kind in the insurance marketplace dealing specifically with a patient’s response to autoimmune biologic drug therapy.

Mark Faiz, president and CEO of Personalized Prescribing Inc., said based on research studies, there’s evidence that only about 65%-70% respond to autoimmune biologics.

No cost to take part

Gaudry said the insurer is reaching out to its eligible plan members who take medication that falls within the scope of the study to participate on a confidential basis and at no cost to them. They will also receive the drug compatibility test free of charge.

However, there’s still more research to be done to evaluate the financial benefits for group plan sponsors.  

“I think that RBC and other carriers and probably the public healthcare system are taking their time to make sure we fully understand the outcome of making the test available before we make decisions on broad-based coverage,” she said.