Canadian HR Reporter

CANADIAN HR REPORTER October 2, 2017 NEWS 9 medications in a bid to pin- point more effective treatment, said Marilee Mark, vice-president, product and integrated health so- lutions, group benefits at Sun Life in Waterloo, Ont. "We're looking at it as a pilot," she said. "We've not added it as a standard benefit to our plans. At some point, we may." Employers offer benefits to en- sure necessary treatments or ser- vices are available to employees and their families, said Mark. "You want to make sure that you're giving the most relevant benefits to an employee that are going to have the best impact on their health. at's where phar- macogenetics comes in." Sun Life clients on an approved mental health-related disability claim who are taking medication as part of their treatment are able to take part in the study on a vol- untary basis, she said. The ultimate goal is to have workers receive effective medica- tion, so they can return to work sooner, while keeping benefit plan costs sustainable for employers. "Pharmacogenetics is a ground- breaking approach to mental health treatment," said Mark, not- ing the earlier a person can get the appropriate treatment in place, the better the prognosis. e study analyzes participants' saliva to identify genetic variants that can influence how they re- spond to common mental health medications. A report is then sent to the patient's physician with a green, yellow or red denotation. Green points to the medication expected to work best, yellow indicates dosage levels may need adjusting, and red denotes medi- cations that should be used with caution. "We'll begin to see how we can leverage personalized medicine in benefits plans overall. This is a good way to take that first step to ensure we've protected confidentiality, privacy and that patient-physician relationship," said Mark. Overcoming privacy issues e recent interest in pharma- cogenetics comes following ex- tensive parliamentary debate on Canada's Bill S-201, which pro- tects individuals' genetic informa- tion and received royal assent in May, said Prouse. A variety of safeguards are in place to keep genetic information private through the testing pro- cess, including voluntary consent and the codification of personal information before saliva tests are shipped to the laboratory, he said. For insurers looking at phar- macogenetics, "it all comes down to employer and employee educa- tion," said Prouse. "All these factors will contribute to a safer situation." Testing is generally conducted through "spit kits" that have cli- ents expel saliva into a vial, then add a DNA isolation buffer before sending it off to the lab. Clients undergoing the tests can choose the specific data they would like to receive from their test via consent forms, he said. Following analysis, the lab will send the green-yellow-red light report to the client's physician, who makes the final decision on possible medical prescription alterations. Throughout the process, it's important the employee has full transparency and remains in con- trol, said Ann Cavoukian, distin- guished expert-in-residence lead- ing the Privacy by Design Centre of Excellence at Ryerson Univer- sity in Toronto. "Privacy is all about control — personal control on the part of the individual relating to the uses of his or her personal information," she said. "When you're talking about mental health issues and medication, this is the most sen- sitive health medication you could ever have." "Like many physical samples, saliva could also reveal additional information about an individual's health, so you would have to be very clear that the only use that could be made of the saliva test was for this particular narrow purpose… which is to assist in finding the best medication for the mental health problem." All of this has to be done very privately through the physician, who will presumably explain to the patient why this is in her best interest to get the best pos- sible medication, according to Cavoukian. "You have to be extremely care- ful whenever you're dealing with sensitive health information." Sun Life, like all insurance com- panies, abides by rigorous proto- cols to ensure compliance with legislation and privacy require- ments, said Mark. Client-physi- cian confidentialities will remain in effect throughout the pharma- cogenetics process. "In doing so, then really there isn't a privacy concern if we're not receiving information that we should not have or would not require, and that informa- tion is not used in any way for disability purposes — it really is strictly related to (best medica- tion) and its always the physi- cian's choice." It's really important to keep the relationship and the decisions between the physician and the patient or employee, said Mark. "e employer would not know that they have an employee who's participating in this study. ere's no need for them to know. It's completely confidential." 'It's completely confidential' SALIVA < pg. 1 A lab sends a green-yellow-red light report to the client's physician, who makes the final decision on possible medical prescription alterations, says one expert. Credit: Sarah Weldon FRGS (Shutterstock)

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