Practice Transformation
A new KFF COVID-19 Vaccine Monitor report finds many individuals who were initially hesitant to get a COVID-19 vaccine in January, but ultimately did get one, say that family, friends and their personal doctors helped change their minds. KFF found that 54% of those who said in January they wanted to “wait and see” have received at least one dose. However, 76% of people who had previously said they would “only get vaccinated if required” or said they would “definitely not” get a vaccine remain unvaccinated. (KFF COVID-19 Vaccine Monitor report; GTMRx report)
Evidence & Innovation
Research published in Nature confirms or identifies 13 genes that appear to play a role in susceptibility to COVID-19 infection or that affect the severity of illness. The same researchers also found 10 new locations in the human genome associated with infection or severe COVID-19. The research comes from the COVID-19 Host Genetics Initiative. “DNA isn’t destiny, but it can load the dice,” Dr. Hamdi Mbarek, research partnership director of the Qatar Genome Program, tells USA Today. (USA Today; Nature)
Many patients may not fully understand their care plans—or their medications—after they are discharged from the hospital, according to The Leapfrog Group’s Patient Experience Report. Although about 87% of patients responding gave their hospital top marks for the quality of discharge information, only 52% gave top marks for providing information about their care transition once they left the hospital. Only 61% of patients gave their hospital the highest marks for communication about medicines, including how often staff explained the purpose of a new drug or warned about side effects. (Becker’s Hospital Review; Leapfrog announcement)
A new consumer survey by the GTMRx Institute finds that nearly a quarter of respondents say their medications are not routinely reviewed and evaluated by their medical team. Moreover, nearly 20% of respondents were prescribed medication from three or more doctors in the past year, leaving even more room for error. This is untenable, says GTMRx executive director Katherine H. Capps. “We must reform the broken process.” The way forward? “Experts agree that widespread adoption of comprehensive medication management is the right path forward to avoid waste and continued life-threatening medication disasters.” (Chain Drug Review)
Policy Solutions
As pharmacogenomics moves into the mainstream, “careful consideration must be paid to inclusion of diverse populations in research, translation, and implementation, in the historical and social context of population stratification, to ensure that this leads to improvements in healthcare for all rather than increased health disparities,” according to research published in the British Journal of Clinical Pharmacology. The research identifies evidence gaps and suggests approaches which may minimize negative consequences and promote health equality. (British Journal of Clinical Pharmacology)
The US life expectancy continues to fall behind that of other countries, and one reason in COVID-19, according to research published in BMJ. The life expectancy gap between the US and comparable countries already increased from 1.88 years in 2010 to 3.05 years in 2018. The researchers found pronounced 2020 losses among the Hispanic and non-Hispanic Black populations. “A longstanding and widening US health disadvantage, high death rates in 2020, and continued inequitable effects on racial and ethnic minority groups are likely the products of longstanding policy choices and systemic racism,” researchers conclude. (USA Today; BMJ)
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In Case You Missed It!
On Friday, July 9, 2021, the Precision Medicine Workgroup, Payment and Policy Solutions Workgroup and PGx Payment and Policy Taskforce held important discussions with Congressional staffers from Rep. Tom Emmer (R-MN) and Rep. Eric Swalwell (D-CA) offices. Congressmen Emmer and Swalwell are the co-chairs of the Personalized Medicine Caucus. During the meeting, Brian Litten, JD, chief strategic growth officer, general counsel and chief compliance officer for Tabula Rasa and GTMRx workgroup member, outlined GTMRx’s position on PGx payment reform (see below), and the Congressional staff discussed draft legislation underway related to physician education, EHR integration and data storage as well as forthcoming payment reform, asking workgroup members for feedback during a robust Q/A session. GTMRx will continue to offer input as this legislation is being drafted.
We are sharing new survey results that assess the medication management habits and needs of over 1,000 people. Nearly one quarter of people cited that their medications are not routinely reviewed and evaluated by their medical team—shocking, given that one-third are taking four or more medications and/or supplements per day. The GTMRx Institute staff, workgroup and taskforce leaders and participants have created a set of tools to help inform and educate the consumers of health care services—and providers who have direct contact with the consumers—about why it’s important to get the medications right. We invite you to read more, share these tools and join us to ensure appropriate use of medications.
Leadership from GTMRx’s PGx Payment and Policy Taskforce and Payment and Policy Solutions Workgroup have created 5 policy recommendations on PGx + CMM that policymakers should consider to ensure that patient medications are managed safely and effectively based on the unique characteristic of an individual patients’ genetic profile, including:
- Add the assessment of patient medications and drug-gene interactions to Medicare (Welcome to Medicare visit) and Medicaid benefits,
- Require CMS to reimburse preemptive multi-gene panel testing as one single test with one standard compensation code,
- Require CMS to reimburse members of the care team trained to evaluate/manage all medications based on patient’s genotype, multi-drug interactions, Rx metabolism, etc.,
- Direct the National Quality Forum (NQF) to review and make recommendations on drug-gene interaction efficacy and safety checks prior/post admin of drugs within CMM,
- Recommend the U.S. Preventive Services Task Force evaluate evidence of PGx testing and CMM, for drugs with known drug-gene interactions, as a preventive health care practice that addresses patient outcomes/medical expenditures and that should be covered by ACA plans.
In addition to development of Vaccine Confidence Leagues (VCLs) and community-building activities, the task force’s recommendations include:
- Accelerated approval of vaccines
- Public education
- Payment reform
- Improved vaccine access for primary care practices
- More effective immunization information systems (IIS)
- No cost-sharing for certain patients
- Enhanced diversity, inclusion, and equity
Find the report Frequently Asked Questions here.
Read the report here.
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