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Varied Access: The Pharmacogenetic Testing Coverage Divide
On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
On this episode of Managed Care Cast, we are speaking with Jai N. Patel, PharmD, the associate director of shared resources management at Atrium Health Wake Forest Baptist Comprehensive Cancer Center.
His study, "Medical Policy Determinations for Pharmacogenetic Tests Among US Health Plans," uncovered significant differences in coverage decisions for pharmacogenetic tests across major US health insurers and laboratory benefit managers. Pharmacogenetic testing examines how an individual's genetic makeup impacts drug response.
In our discussion, Patel shares what motivated this research, key takeaways from his findings, and steps needed to improve consistency in evidence evaluation and pharmacogenetic test coverage.
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