PO - Expand DNA Testing to Improve Precision MAT Therapies

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Examples of a Description for this Objective

Improving MAT plans through the use of DNA tests has the potential to greatly improve the effectiveness of MAT and reduce the high relapse rate that is common even with MAT. That not only helps people stay on the path to recovery, but it also saves money that is spent when people continue to relapse. Adding DNA tests to inform the MAT process is one of the key ways to optimize MAT that doesn't require major new programs or facilities. It simply allows existing treatment dollars to be used more wisely and effectively.
 

Examples of a From-To Gap

Current State Desired State

Most healthcare providers have limited education on pharmacogenomics.

Through a variety of continuing education modalities, most healthcare providers appreciate the power of precision medicine and the value of more exact dosing of medication informed by DNA testing.
MAT plans are based on "hit or miss" practices that are not optimized based on individual genetic makeup. Nearly all MAT is guided by genetic testing.
Most Healthcare professionals who are licensed to offer MAT (e.g. able to prescribe Buprenorphine/Suboxone) are not aware of precision MAT or how to use DNA testing to optimize dose and MAT plans. Training to become licensed to prescribe MAT does not include education on DNA test and precision MAT. As a result of targeted supplemental training, all healthcare professionals who are licensed to prescribe MAT are also trained in DNA testing and precision MAT. Training to allow people to be licensed to prescribe MAT has been updated to cover DNA testing and precision MAT.
Medicaid often doesn't support MAT and is even less likely to fund DNA testing for precision MAT. States specifically adopt Medicaid policies that reimburse for DNA tests to enable precision MAT and pay for precision MAT.
Funds for addressing the opioid crisis (e.g. STR funds) are used primarily for Naloxone (Narcan) and for the medication that is not very effective if not combined with DNA testing to allow precision prescribing. States allocate parts of STR and other funds to include DNA testing to enable precision MAT, resulting in greater successful recovery.
Commercial insurers are inconsistent in paying for DNA testing to enable precision. (About 30% will pay for the DNA testing). The vast majority of commercial insurers pay for DNA testing to enable precision MAT
The broader spectrum of people working with treatment and recovery for substance abuse (or loved ones and other caring people) have little awareness of the power of precision MAT. Because of the lack of appreciation of precision MAT, people making decisions about where people with OUD should get treatment are poorly equipped to make good choices. With broad awareness of the value of precision MAT, they can choose to direct people (and resources) to recovery programs that use precision MAT. This creates an incentives for treatment programs to learn about and use precision MAT.
Because of the lack of appreciation of precision MAT, the long-term success rate of most treatment programs is low, and the "revolving door" results in poor use of scarce treatment resources. High quality treatment programs can differentiate themselves by offering precision MAT.
Most states have a big shortage of treatment beds for people with OUD. Many people with OUD can be treated with a successful out-patient program based on precision MAT integrated with whole person care and supporting technologies. With far fewer people relapsing, the existing inpatient beds will meet more needs.

 

Examples of Current Activities