Access, Efficiency, and Economics: How Precision Medicine Fuels 2025’s Waves of Change

By Joe Spinelli, chief strategy officer, Aranscia.

2024 left us with raw emotions, sentiments, and uncertainty around how the US healthcare system will support both the commercial and political promises of excellence and value in care for all.

Faced with ever-escalating costs, and rate-limited access to effective care for an increasingly greying population, we are left with no choice but to embrace novel approaches to identifying, facilitating, and incentivizing proactive care improvement and efficiencies. The only thing certain about 2025 is that it will not be business as usual.

Initiatives to further the personalization of health care extend beyond embracing best practices for high-risk and high-cost cohorts – they also empower the broader population of patients and clinicians with access to evidence-based insights to drive both proactive and preventive benefits. The field of personalized medication management and the utilization of drug-gene testing (also known as pharmacogenomics, or PGx) can truly support a trifecta of improving access, efficiency, and economics.

What problems can personalized medication management solve?

Adverse drug events are the fourth leading cause of preventable death in the US, and downstream issues related to ineffective medications or unwanted side effects create a significant cost and care burden on our healthcare system. In contrast to one-sized-fits-all prescribing, which has traditionally aligned care providers and pharmacy benefits with a “standard” regimen irrespective of its assessed compatibility with the patient, personalized medication management programs use a combination of tactical diagnostic testing and high-evidence clinical insights to assist providers in optimizing therapeutic decisions.

How are biomarker programs like PGx being embraced nationally?

Widespread state and federal initiatives have recognized the value and benefit of improving the accessibility of PGx testing.  Over half of the US states now have legislation in force or introduced to enhance coverage for biomarker testing programs like PGx, and they have overwhelmingly received bipartisan support.

While the federal legislative priorities for 2025 and beyond remain uncertain, key thematic elements of personalized care, use of evidence-based science, and operational efficiency are highly compatible with the key tenets of PGx programs at scale.

Is the industry coalescing around best practices?

In general, yes. Many of the leading clinical, program, research, and academic minds in pharmacogenomics have been hard at work to develop consensus guidelines, and I would expect to see them become more prominently used as a baseline measure of diagnostic and programmatic quality in 2025. Compared to other areas of speculative genetic testing that are purely focused on data aggregation, PGx industry leaders remain highly focused on unlocking and maximizing the immediate tactical utility of programs to help improve outcomes and lower costs.

Where would AI tools and resources fit in with personalized medication management programs?

Unlike many fields benefiting from automation in back-office and research capacities, personalized medication management is most effective when insights are directly incorporated into a clinical workflow, rooted in true evidence-based science, and applied in tandem with other aspects of an overall clinical assessment to develop a patient’s treatment journey.

Optimal ways to utilize advanced ML and AI technologies in this space are to help democratize data access, route insights, synthesize discrete data elements, and support post-intervention outcomes tracking.

How do value-based care programs think about personalized medication management?

PGx programs were traditionally aligned and concentrated in their studied impact on pharmacy, but as time has progressed, study after study has confirmed PGx programs’ strong economic benefits – including their ability to reduce overall health care costs and utilization. These findings make personalized medication management a natural fit with ACOs, self-funded employers, and other value-based care programs that already focus on opportunities for high-impact interventions designed to improve care and lower costs.