Year: 2011-12

Company: Medco Health Solutions

Liaison(s): Lon Castle

Medco Health Solutions, Inc. is an American pharmacy benefit manager (PBM) that provides pharmacy and other healthcare services for private and public employers, health plans, labor unions, government agencies and individuals served by Medicare Part D. Founded in 1983, Medco covers approximately 65 million lives and uses its expertise to provide mail order pharmacy benefits, clinical services supporting appropriate medication use, and evidence-based interventions to improve the quality of healthcare. As a pharmacy, Medco processes prescriptions and uses its size to negotiate with drug manufacturers and pharmacies to reduce the overall cost of medications for its clients and their members. Medco is in the process of evaluating how advancements in whole genome sequencing (WGS) technology will impact healthcare delivery within the next 3-5 years. Medco believes it can leverage its broad datasets and experience in genomics to become a leader in the integration of WGS into clinical care. However, significant hurdles exist to successfully gain physician adoption of WGS. Medco would like to understand these barriers and determine the best way to overcome them in order to successfully accelerate the integration of this evolving science into clinical practice. The Medco TMP team was tasked with developing a decision framework by assessing how various dynamics will impact the development of WGS and how this technology might be integrated into Medco’s existing, and possible future, service offerings. The team investigated where Medco’s current infrastructure would need to be expanded and how the technological feasibility, legal and regulatory environment, and market factors would impact Medco’s decision to move into the WGS space. Through identification of key variables involved in WGS, the Medco TMP team identified several potential program offerings that Medco could implement. In addition, the team created a quantitative model to guide future decision-making as the field continues to evolve. Through this project, Medco has gained a clearer understanding of what role WGS plays in their existing business model and how this model can be expanded to provide maximum clinical and commercial value for its clients and their members.