We are here today speaking with Ted White, Jr., the Chairman of BH Genetic Solutions, an industry leader specializing in PGx and healthcare technology solutions. BH Genetic Solutions, in partnership with Aeon Global Health, are Diamond sponsors of our 9th Annual Employer Healthcare and Benefits Congress.
ROB: Ted, Welcome!
Thank you for having me.
ROB: Ted, can you explain what the term "Pharmacogenomics", or PGx means?
The term "pharmacogenomics" is derived from "pharmacology", which is the study of the uses and effects of medications, and "genomics", which is the study of genes and their functions. So putting the two together you come up with "pharmacogenomics", or PGx for short. The term PGx stands for the test that analyzes your DNA to help a doctor determine what medications and dosage levels are right for you.
To do this, BH Genetic Services has chosen to partner with Aeon Global Health to offer custom PGx testing services for patients and physicians throughout the United States. We chose Aeon because they have been a leader in the market for pharmacogenomics and precision medicine testing since 2012, so we are pretty excited about this partnership.
ROB: How did this PGx technology get started?
It all started with the Human Genome Project that was completed in 2003. Back then it took $2.7 billion and fifteen years to complete. In 2008, it cost $10 million to sequence a person's genome. Today it costs less than $1,000 and takes only a few days.
Interestingly enough, you have Dr. Craig Venter coming to be the closing speaker at this year's Employer Healthcare & Benefits Congress. He was the one who developed the technology to perform faster DNA sequencing helping make it affordable for broad use. Without him, we might still be trying to figure this all out!
ROB: Why did you decide to enter this business?
My background is in the insurance industry. I started out as an agent for a top national senior insurance marketing company, became agent of the year, developed an ancillary health company and was one of the first to bundle multiple benefits and took that company public. Later I ran large regional insurance agencies for three separate national companies.
My goal was always to collect all the data from the client by doing a thorough needs analysis first, then find ways to reduce my client's costs to free up money and use those savings for other products and services that would benefit their families.
ROB: A typical needs analysis by today's standards.
Right. I always asked the question: "If I can offer you more benefits for equal or less than you are currently paying for your premium, would you be interested?" The answer was always yes and I was able to review the needs analysis form, identify where I could save the client money, and then fill gaps with better products at a lower price.
ROB: So, how does today's version of a needs analysis apply to the PGx testing process to save employers money?
The same needs analysis principal application applies to our platform of products and services. The utilization of pharma data algorithms to reduce pharma claims by identifying propensities out of the total employer community population is key.
By identifying which employees would benefit from a PGx test, a turnkey DNA swab test is prepared by the employee and seamlessly flows through a platform integration with a telehealth doctor which connects directly to our lab partner, AEON.
ROB: When the results are generated by AEON, what happens to that PGx data?
The results from the PGx test reports back to our Telehealth doctors and then to the patient and their primary caregiver. The test results will recommend to the primary care physician which prescriptions if any, the employee should be taking based on the PGx and DNA test results.
ROB: Who pays for the tests and how does the billing work?
The claim will flow through our proprietary billing and reimbursement platform. For fully-insured employers, the billing is sent to the carrier. The costs vary, depending on the carrier, and their history of approved payments.
ROB: So how does this reduce prescription drug claims and save the employer money? TED: This leads to a defined ROI
This leads to a defined ROI for the employer, which reduces their healthcare claims. Utilizing our telemedicine program for their employees will lead to the same result that flows through our platform technology.
ROB: How long has it taken you to develop this technology?
Nine years ago, I had the vision to bring that same focus to the healthcare market using a technology platform so that employers had a way to reduce their healthcare costs. Technology finally caught up to my vision.
ROB: There are other companies in the pharmacogenomics business. What makes you different?
Our platform. We call it "The Power of the Platform". Our platform enables us to do several things. There are five areas I would like to briefly address that sets us apart from our competitors. First, it automates the process of onboarding, training and certifying brokers, employers, HR professionals, and physicians. This allows us to bring our vision to literally hundreds of thousands of professionals with basically the flip of a switch.
Second, it allows us to automate the genomic testing process. With most other labs, this is a manual process. Our platform enables us to run tens of thousands of tests each month. We have also integrated our TeleHealth platform to scale the doctor consultations required to order the tests so that we can reach the large volume of patients who desperately need this technology.
Third, we can deliver, at scale, complete benefit packages to improve the overall wellness of a company's workforce to further reduce healthcare costs. Fourth, we have an advanced algorithm that I just mentioned that we can run against an employer's employee database. This will show which employees will benefit from a PGx test, and will provide the employer an ROI up front.
The analysis is free. Of course, we have to charge for the tests, but the savings will far outpace the costs of the tests, producing that ROI I just mentioned. Finally, we have integrated our entire platform with Salesforce as the CRM, allowing all our brokers and partners to see in real-time the status of all leads, tests, costs, and commissions to brokers.
And Salesforce, in turn, sits on top of our own proprietary platform that, among other things, also automates all these processes. No other company has this level of integration and power. That was the vision I had nine years ago, and today it has come to fruition.
ROB: You certainly have a vision, Ted. Let's get back to PGx. What is a PGx test and what does it show?
Our genes and DNA determine everything about our bodies.They determine our eye color, hair color, our blood type, and shoe size, and many other things. And some genes are responsible for how our body processes medications. The PGx/DNA test analyzes a person's genetic variants that influence the function of the drug metabolizing enzymes in our bodies.
This determines how our bodies metabolize drugs, which are broken down into metabolic phenotypes. There are four metabolic phenotypes: Ultrarapid Metabolizer; Extensive Metabolizer, which is the most common; Intermediate Metabolizer; and Poor Metabolizer. If a person is a Poor Metabolizer, their body may break down a specific medication too slowly.
This may cause the medication to build up in the body causing severe side effects. Keep in mind, taking the initial dose of a specific medication may not have an immediate adverse reaction to the patient. However, a poor metabolizer will build up the medication which could create an adverse reactions days or weeks after the medication is initially taken.
Another person's body may break down the same medication too quickly. This person is called an Ultrarapid Metabolizer, which doesn't allow the drug to work effectively. That is why some people don't feel the effects of a prescription. Without the proper understanding of how the patient's DNA is dealing with the prescription medication, physicians would either increase the dosage or recommend another prescription, which may have the same metabolic reaction as the initial medication.
ROB: Why is understanding this important for us and how can this help the patient and physician?
Our genes/DNA determine everything about our bodies. So, reading the test results, and knowing what I just explained, a doctor will have a better understanding of which medications to prescribe and a more accurate dose for their patient. This is not a widely-known fact, but over 100,000 people die each year in hospitals from receiving the wrong drug, or the wrong dose. In fact, this is the fourth leading cause of death in the U.S. each year.
ROB: Earlier we mentioned ROI. Do you have any statistics relative to the annual spend on adverse drug reactions?
In fact, we do. It is not widely known, but our data illustrates that for every dollar we spend on pharma each year, we spend $0.50 on adverse drug reactions, those reactions caused by the patient receiving the wrong drug and/or the wrong dose. This leads to additional prescription drug costs as well as additional medical care, and even the death of the patient.
ROB: So it seems these PGx tests can provide specific information on a patient to help our primary care and other physicians distribute a better quality of care for patients?
Rob, simply put you bet! The bottom line is this, a PGx test can be a lifesaver for many people. And we want to help as many people as we possibly can.
ROB: Going back to the annual prescription drug spend! Wow, 50 percent of the annual drug costs are wasted due to adverse drug reactions. Not only is that concerning from a cost standpoint, but now I am more concerned about the quality of care we are receiving. What is involved in taking a PGx test?
It is actually a very simple process. I have done it, and I can tell you it is easy. You get a test kit with two swabs. You swab your cheeks twice, each for about thirty seconds or so to get a good sample. The reason we do two swabs is to ensure the accuracy and quality of the test.
Then you put the swabs in their sealed packaging and drop them in a pre-paid FedEx or UPS envelope and send it to the lab. Within about a week you get your test results back.
ROB: Who should be tested?
Well, of course, we believe every person should be tested (laughs). But we didn't think that could be a reality. Until now. The Mayo Clinic recently did tests on 1,000 random participants from its Biobank. The results were astounding. Ninety-nine percent of the participants had at least one DNA gene variant of concern.
What that means is that ninety-nine percent had at least one genetic variation that could cause an adverse effect. The doctor at the Mayo Clinic who ran the test said that everyone would benefit by having a PGx test. That is a powerful statement!
ROB: How does this PGx test fit in the overall healthcare discussion, in light of our ROI discussion?
As we stated previously, one of the largest expenses most companies have with their healthcare plan are pharmaceutical costs. History with PGx testing shows that an employer could save about $600 per year per employee just on their pharma claims. That could be over $500,000 for an employer with just under 1,000 employees.
ROB: Now that is an ROI worth sharing with an employer. Ted, are there other expenses an employer can reduce with PGx testing?
Glad you asked that Rob. As you stated earlier, another large healthcare expense -- perhaps the largest expenses employers face -- are the costs of hospitalizations, emergency rooms, and urgent care visits as a result of adverse drug reactions. Not to mention the additional cost of employee absenteeism. Add this all up, and we visualize that this process can reduce healthcare costs by 30 percent.
ROB: I totally understand the prescription drug and medical expense savings and that does add up, but you mentioned employee absenteeism. I read back in 2016, the average cost of employee absenteeism is around $3,200. I would imagine at least 20 percent of that number is related to employees taking the wrong medications. That is another $600+ annual ROI.
Rob, I could not agree more.
ROB: I think our broker network would be anxious to learn how to get involved. What would you tell the brokers reading this on why they should care about PGX testing, and how they could get involved?
First, brokers should care because they now have something to offer their clients that can provide real savings on their clients' healthcare expenses. Most of the time, when brokers are talking to their clients, it's about selling them something. Now they can talk to them about how they can save them money.
Remember how I started? I showed my clients how I could save them money first. I was not there to sell them something. Getting involved is easy. The best way is to stop by our booth at the Congress! If brokers stop by and register, we will have some nice gifts to give them, along with all the tools they need to start to show their clients how they can save them money.
ROB: We also have readers who are HR professionals. What would you say to them?
That's a great question. I think the real issue is motivation. Let me explain.What is the motivation for an HR person? They do a good job for their company, and they get a salary. But real change is difficult. Motivation to affect real change is difficult.
What if the HR professional could show their employer how to save millions of dollars per year by incorporating the technology we have been discussing? And what if the employer were to bonus their HR staff based on their savings? Now we're talking motivation.Not much happens without it.
ROB: So, what are your suggestions for employers?
I would suggest employers explore the opportunity to learn more and better understand how PGx can help them to create a healthier community that is more productive with happier and healthier employees.
ROB: If a company wanted to test their employees, what is the first thing they need to do?
I would suggest they partner with a leader in this space, such as BH Genetic Services. We can schedule our team to onboard their employees and to schedule the consult visits with those who have been identified as the best candidates by the algorithms that I mentioned earlier. This process will create significant ROI for the employer.
ROB: So, let me get this right. You are telling me that if a company were to test its employees, their overall healthcare costs would go down, their pharma costs would be dramatically cut, and their employees would be healthier and more productive?
Exactly. Plus, the telehealth combination of the PGx testing and then having the ability to utilize the telehealth option year-round will generate further ROI by reducing other healthcare claims for the employer.
ROB: This almost sounds too good to be true.
Well, let's think about it for a minute. What do doctors do now? They give you a prescription that they don't know for sure will work. This is called the "trial and error" approach. Again, that is why we spend $0.50 on adverse drug reactions for every dollar we spend on medications.
But, if a doctor knows exactly what drug will work or not work and what the right dose should be, all based on your DNA, the guesswork is gone. Before the Human Genome Project, this would have been impossible.
ROB: So, what was impossible is now possible.
ROB: I think our readers have something to act on. Any final thoughts,
Yes. Our mission is very simple: "We reduce healthcare costs with proven ROIs". We look forward to making a difference to help the employers and HR and broker representatives in the marketplace who are attending this great event.
We are hopeful that our platform will lead to effectuating changes in the healthcare industry. I do feel we are on the right track as a company that cares about the employers, employees and their families and to let them know that our company is actually doing something about the problems employers are facing in providing healthcare.
We have a very clear pathway to provide market solutions that do exactly that- reduce healthcare costs for employers.
ROB: Ted, on behalf of Global Healthcare Resources, I would like to thank you for taking the time to visit with us today to explain this amazing new technology in the health and wellness space. Thanks again, Ted.
Thank you so much for the opportunity to be a part of your 2017 Employer Healthcare and Benefits Congress and for taking the time to better understand the PGx process.