Offering pharmacogenomic (PGx) testing creates numerous opportunities for independent pharmacy – increases patient retention, ensures the most comprehensive care, strengthens relationships with doctors and rapidly builds a new cash revenue stream, to name a few.
While little clinical training and overhead are required for personalized medicine, your success hinges on a key element: partnering with a reputable lab that compliments your pharmacy’s goals and infrastructure. On a recent members-only Pharmacy Advancement Academy webinar, How to Create a Profitable Pharmacogenomics ServicePDS Members Amina Abubakar and Olivia Santoso Bentley of Rx Clinic Pharmacy shared what they’ve learned throughout their journey of becoming one of the industry’s leading PGx providers, here’s what they had to say:
To ensure you have reliable information, ask to speak with the billing department and lab and discuss the following questions.
- Are you a distributor or an actual lab? You will want to determine if you are working directly with the physical lab that processes the tests, or a distributor. While there may be benefits to working with distributors, make sure that they’re offering you value and transparency in regards to billing and payment processing to ensure that this is a better option than just working with the lab. For example, if the lab you choose only offers the testing and outsources the clinical education and implementation materials, you can feel more comfortable around the value that a distributor partnership is offering.
- How will my pharmacy be paid? It is essential that the lab is transparent with their payment structure, especially if they are billing insurance. The monthly reports the lab provides should clearly state how many tests you distributed, what’s being billed and what’s being paid to you. For labs offering an insurance billing model, there should be transparency around the rejections, with the EOBs from the insurance companies. It’s also important to discuss if you’re getting paid per test or if you’re only getting paid what you collect. Also, what exactly is your role in the PGx process? Are you just paid for the collection or the medication review or both? Some labs have a pharmacist who will perform the review, and you’re just the collector.
- Will you be able to support my pharmacy’s infrastructure? Every pharmacy is designed a little bit differently, and your lab should fit your needs. For example, if you’re technologically savvy, is the lab? Will they fax you everything or will they create a portal for you to house everything electronically? It’s highly recommended to work with a lab that will provide you an online portal to streamline all of the paperwork and keep the pharmacy clutter free. Some labs will say you need to have a separate portal or login per doctor. We suggest working with a lab with one portal and one login, regardless of the number of doctors. The lab may even be able to provide portals for your doctors so they can pull the tests whenever they want. It’s also nice if they can provide you with logins for your patients, making it easy for them to access their data. Just be sure the portal has your name on it so you get the brand recognition!
- What size panel does the lab run? How many drugs, biomarkers, Apo E lipids, etc., do they offer? Is it an extensive panel or only for a few pathways? You want your tests to be as comprehensive as possible and for the lab to be continually adding more biomarkers and enzymes as technology advances. Some labs offer a lower cash price point for a fewer-panel test. Ask the labs about their panels and which drugs and disease states are covered and determine the best fit for your patient demographics.
- Will you provide customized marketing materials? They are the experts in this arena and have likely invested a lot of money in research, branding and marketing campaigns. Request to see their collateral for patients and doctors and to have them print it for you with your logo.
- How will you train my team? Is the lab willing to invest in training so you and your team are confident in administering tests and consulting your patients? Most labs have a clinical team in place who can get you up to speed on which CYPs they’re testing for and what poor metabolizers, fast metabolizers and everyone in between needs to know about their genetics and their medications.
- What does the next 1-3 years look like for your lab? You’ll want to ensure that the lab you choose is willing to think ahead and collaborate as your business grows. For example, when Amina started offering a PGx service in her business, it was easy to track patients with a simple prompt in her computer system, but as she’s grown, there’s now a need for full integration. The lab she works with, MD Labs, was willing to have conversations with her software company to determine a solution.You’ll also want to confirm that the lab will be continually working to include more biomarkers in their panel and that patients who received their initial PGx results in 2015, for example, can be re-run as new information emerges, making it a “once-in-a-lifetime” test.
- What happens if my patient’s insurance isn’t accepted and we’ve already submitted a test? If a lab is offering to bill the patient’s insurance, be sure to question what will happen if it’s not covered. You don’t want a patient or a physician upset at you because now they owe the lab $1,000 for their genetic test when you told them it was covered by their insurance.
- What disclaimers do you include with your tests? If you’re out there promoting these tests, the lab needs to include disclaimers on their materials that not only protect you, but also the doctors. For example, you do not want a patient to get upset at the doctor because they prescribed a medication that happened to be on this test that they couldn’t take. The disclaimer should also help the patient understand that they need to take responsibility and share the information with everyone involved in their care. Amina suggests working with a lab that’s also flexible with changing wording and adding things to the forms to ensure everything protects the pharmacy and providers. Nothing should ever be set in stone!
And remember, not all labs are created equal. Researching multiple labs will ensure the highest ROI, most comprehensive panel and support.
Want to Quickstart Your Pharmacogenomics Program?
PDS Members, log into PDSadvantage and search “PGx” to access a seven-step implementation manual, webinar, a project plan and turnkey templates that outline how to…
- Provide the most comprehensive care to your community
- Pick a reputable lab
- Sell your PGx and MTM services
- Collaborate with doctors
- Seamlessly integrate PGx into your workflow
- Properly train your team
- Add $25,000 to your bottom line
Not a PDS Member? Speak with one of our Business Advisors today and immediately gain access to the PDS Resource Library with 100s of templates, tools and programs for growing and differentiating your business.
Ready to learn more about Pharmacogenomics? Watch our free webinar for a thorough introduction now.