Benefits snapshot: pharmacogenomic testing

by | Dec 11, 2020 | Take 5 Articles

RECENT POLL BY TELUS HEALTH found that 10 out of 10 insurance carriers in Canada offer at least one option to help plan members cover the cost of pharmacogenomic (PGx) testing, which uses DNA results to determine which medications are most likely to be effective for an individual.

Canada Life, Desjardins, Green Shield Canada, SSQ Insurance/La Capitale and Manulife most recently announced new offerings by the end of this year or early in 2021. For example, Canada Life has launched a preferred pricing arrangement for plan members with extended health benefits, adding to its disability benefit for PGx testing that’s been in place since December 2017. The article includes a chart that captures the specifics of coverage for all 10 insurers.

In summary, eight out of the 10 cover PGx testing as a disability benefit, though some limit its availability to those with a mental health condition or chronic pain. Five insurers offer or will soon offer coverage as an extended health benefit, typically for the full range of conditions for which testing is available (i.e., mental health condition, chronic pain, cardiovascular conditions, nervous system disorders and attention deficit hyperactivity disorder). Three insurers have put preferred pricing arrangements in place with a testing provider (retail prices for a kit range from $300 to $500).

This article is part of The Benefits Alliance Take 5 for Health Benefits. Take 5 is a quarterly initiative that provides a deeper look a the employee benefits space by providing examples, research and case studies on what’s working for employers in Canada.