One-on-One with the National Alliance of Healthcare Purchaser Coalitions

Mike Thompson, President & CEO of the National Alliance of Healthcare Purchaser Coalitions, Interviews Scott Megill, President & CEO of Coriell Life Sciences

Mike Thompson:

Hi, this is Mike Thompson with the National Alliance of Healthcare Purchaser Coalitions. And I’m here today with Scott Megill, who’s the president and CEO of Coriell Life Sciences. Scott, I was really interested to hear that Coriell Life Sciences, isn’t a pharmaceutical company producing precision medicine, but rather is in the business of taking the promise of precision medicine and implementing that – helping organizations, self-insured employers, and other payers implement precision medicine.

Scott Megill:

That’s right, Mike, and thanks for your time this morning. Coriell Life Sciences is actually a commercial spin-out from the Coriell Institute for Medical Research. So, our background is really in understanding and discovering new science, not new pharmaceuticals. So, our focus is really on how we can make better use of genetics to deliver the right care to the right people and understand, at population scale, how do we actually implement that in a non-disruptive way?

Mike:

You’ve talked about delivering the right care to the right people. This isn’t just about covering pharmacogenomics. It’s about how one covers pharmacogenomics and when you’re determining the right people that isn’t a one size fits all. You’re actually considering the holistic factors, the bio-, psycho-, social factors that would make pharmacogenomics actually improve clinical and financial outcomes downstream.

Scott:

Fundamentally, the science is only as good as the ability to get it to the right people. So, you really have to understand first, what makes the use of genetic testing appropriate for one person and not another. And, ultimately, we operate inside of a healthcare system that’s driven by cost factors. And so, a lot of that does have to be driven by how can we reduce the utilization for individuals on the health care system? That oftentimes means getting them care that’s more appropriate for them. But sometimes it means taking them off of pills that aren’t working. This is the kind of intervention that really seeks to determine that so that we can really align the right medication plan to the right person, reduce those adverse events, and ensure that the pills that they do take are ones that are going to be efficacious for them.

So, the basic science itself, I think, has stumbled a bit in its implementation over the last decade or so, because there’s been so much focus and so much of it driven by laboratories to just simply test people; just test them for their genetic variation and what that variation might mean for specific medications. But as you say, that really is missing, most of the picture. Genetics really cannot be taken in isolation. It needs to be put in the context of everything else that is really going on with that individual. So we have to look at how those drugs behave together at a chemical level, how they behave with the foods that people eat and drink, the things they smoke, the things they eat, the lifestyle factors outside of just food and drink, and certainly the conditions they suffer, their age, whether they’re pregnant. All of those things that would be part of a traditional comprehensive medication management process, but now introducing the genetic component as part of that overall decision-making. And of course, all of that is an evolving space. So, that has to be done in real-time as both the technology and the science emerges.

Mike:

And Scott, this is a highly changing area. Pharmacogenomics continues to grow year after year. And employers often struggle with, what works, what doesn’t work. You’re in that continuous process improvement modality, right? You’re studying continuously at the employer level and more broadly what’s having an impact, and when is the optimal use of these interventions? Can you talk about that approach?

Scott:

We do put a heavy emphasis really on delivering precision medicine at two levels. Obviously at the individual level, providing the right care to the right person, but also understanding at the population level, who are the right people to really focus on for this kind of a program. And that really requires an in-depth analysis of the utilization of the healthcare system among that membership. So, typically that’s an analysis of claims data and EHR information, if it’s available, and ultimately deciding who really are the right people that we should make eligible for the program, who should we do outreach to, who should we encourage to participate. And then ultimately, how do we measure the impact of this program over time? So, we baseline at the start: Here’s what our current spend is for individuals at certain risk levels that have been quantitatively scored for their healthcare risk, and then identify across the longitudinal delivery of the program.

What impact has this program had beyond any other programs that are running inside of that healthcare benefits system itself? So, what we’ve done is to really provide that information as an ongoing vigilance service throughout the entire running of this kind of implementation so that our customers and our partners have an opportunity to see what’s working and what’s not working, and can make adjustments along the way. So, what really is key to all of this is, we don’t have all of the answers today. New answers are emerging all the time, but the answer is we do have a really driving significant impact. So, we’re seeing programs that have been running with us for three years now, with an average annual savings of about $5,400 per person. So, that’s pretty significant, and that’s over-and-above the cost of the program itself. So, that’s true savings being realized by the plan, by the payer itself. So, really significant when implemented in the right way.

Mike:

Scott, thank you so much for speaking with me today. It’s clear that Coriell Life Sciences is really positioned to be kind of a partner with employers in managing this emerging area of science and doing so in a way that consistently delivers value for them and their employees. So thank you, Scott, and I look forward to working with you over the next few years, and we’ll talk to you later.

Scott:

Thank you, Mike.

About the National Alliance of Healthcare Purchaser Coalitions

The National Alliance of Healthcare Purchaser Coalitions (National Alliance) is the only nonprofit, purchaser-led organization with a national and regional structure dedicated to driving health and healthcare value across the country. Its members represent private and public sector, nonprofit and Taft-Hartley organizations, and more than 45 million Americans, spending over $300 billion annually on healthcare.