The Teachers’ Retirement System of the State of Kentucky

Case Study

This state-run pension program initially covered approximately 33,000 retired teachers (now 37,000), ranging in age from 62 to 107 (now 109). At 65, their members take an average of 15 prescription medications per year—in addition to over-the-counter medicines, vitamins, and supplements. That’s a lot of copays and a lot of potential for side effects, adverse drug reactions, drug-drug interactions, and drug-gene interactions.

This group retirement plan was looking for an innovative solution to simultaneously lower healthcare costs while improving the health and satisfaction of members. In April 2017, they turned to Coriell Life Sciences.

As part of our turnkey, DNA-based medication management program, we began with a population risk assessment. Using the group’s claims data and our Comprehensive Health Insight Portal (CHIP), we found that almost 84% of members were on at least one drug known to be affected by genetics. Immediately, the group learned that 23,000 of their 33,000 members needed to stop or change at least one medication. We were able to give the plan administrators a sense of how much they could save by leveraging pharmacogenomics and which cohort of members would be most likely to benefit from PGx testing.

We reached out to these high-risk members first, inviting them to be tested as part of a free service offered by the retirement plan. CLS is handling everything, including invitations and enrollment. Members who agree to participate are sent a saliva collection kit that they then ship to one of our network of laboratories for DNA analysis.

For each member, we run the DNA analysis through our own interpretative algorithms to generate a detailed and personalized medicine report. This report includes pharmacogenomic alerts as well as known drug-drug interactions, lifestyle factors, age-related toxicity risks, FDA black box warnings, and medication risks associated with cognitive impairment. The interactive report is then subjected to pharmacist review to develop a recommended Medication Action Plan (MAP) shared with the member and their primary care physician.

Throughout the program, a dashboard allows the plan administrators to monitor overall member enrollment and progress through the system. The administrators receive general financial and plan statistics, while members’ individual health privacy is maintained.

Results Thus Far

64

resulted in medication change recommendation

87

of recommendations accepted by prescribers

11

reduction in pharmacy spend

22

reduction in hospitalizations

27

reduction in slip-and-falls

14

reduction in charged amount

3.2

increase in control group

Reactions From Members

“It’s been years since I’ve seen something come through to make me stop and say, ‘Wow! This is a great idea.'”

“This is wonderful! It’s nice to see TRS participating in new and more exciting things.”

“This is what health care should be.”

Last Updated: October 27, 2020