44% Reduction in Drug & Medical Spend
A self-insured Midwest employer brought RxMapper to their 1,941-member health plan. Here's what happened when DNA-guided care replaced trial-and-error prescribing.
Client identity has been omitted to protect confidentiality. All data is drawn directly from RxMapper's semi-annual program review. Results may vary by population and plan design.
Program Overview
From Medication Monitoring to DNA-Guided Care
RxMapper continuously monitors all plan members for medication risks, then invites the highest-priority members into a full DNA sequencing and clinical consultation program. Of 90 eligible members, 24 were sequenced and 22 completed full consultations with actionable recommendations — averaging 1.91 recommendations per member.
91.6%
Actionable Recommendations
RxMapper's rigorous inclusion and screening criteria ensure that only the right patients are prioritized — resulting in 91.6% of sequenced members receiving clinically meaningful medication recommendations.
83.3%
Moved to More Effective Medications
The majority of members were guided from medications their DNA indicated were ineffective, to alternatives with a genomic basis for success — at no additional drug cost to the plan.
8.3%
De-escalated to Lower-Cost Alternatives
A meaningful subset of members were transitioned from expensive specialty drugs to more affordable, equally or more effective generic alternatives — simultaneously improving outcomes and reducing spend.
Financial Impact
Before & After RxMapper
Drug costs for the 24 sequenced members are directly tracked. Medical savings are projected using published cost-of-care models for effective vs. ineffective medication management.
Drug Spend
Trial-and-error prescribing generated $152,968 in annual drug costs for sequenced members. DNA-guided recommendations reduced that to $91,260 — a 40% reduction.
Before
$152,968
After
$91,260
40%
reduction
$61,708 saved
Medical Spend
Ineffective medications don't just fail — they drive cascading medical costs: additional visits, complications, and hospitalizations. Based on published cost-of-care models, effective medication alignment is projected to reduce annual medical spend by an estimated 45%.
Before
$646,154
After
$352,380
45%
reduction
$293,774 saved
Combined Savings
Across drug and medical spend, the program delivered $61,708 in directly tracked drug savings and projects an estimated $293,774 in medical savings — for a combined estimated impact of $355,482 from just 22 members, with compounding savings expected in years two and three.
Before
$799,122
After
$443,640
44%
reduction
$355,482 saved
Clinical Examples
Real Members. Real Results.
All patient details have been de-identified. Fiscal impact figures are estimates based on published clinical cost models.
Clinical Example
Severe Anxiety & Uncontrolled Psoriatic Arthritis
43-year-old female
Patient had been struggling to find effective medications for both her anxiety and psoriatic arthritis. Her existing biologic therapy was not controlling symptoms.
Recommendations
- Switched from a high-cost biologic (Cosentyx) to a targeted topical agent (Vtama) based on lack of an arthritis component to her psoriasis — a distinction her DNA profile helped clarify
- Switched anxiety medication from sertraline to fluoxetine based on genomic markers indicating better efficacy and fewer side effects
Outcomes
- Anxiety symptoms improved significantly — from severe to moderate impact on daily life
- Biologic discontinued in favor of more appropriate, far less costly topical therapy
Fiscal Impact
$72,240 estimated annual drug savings from biologic switch alone
"There are a lot of people who feel like puppets, trying all different medications to find what works best. No one else is trying this type of thing to see what could actually work best. I would recommend RxMapper services to friends and family if it were affordable and accessible to them, as my employer has made it for me."
Clinical Example
Chronic Migraines, Anxiety & Depression
34-year-old female
Patient had tried multiple prior therapies for her migraines without adequate relief. She also struggled with persistent anxiety and depression, compounding her daily impairment.
Recommendations
- Initiated nortriptyline — chosen for its genomic profile showing decreased risk of side effects, combined with known efficacy for migraines and mood symptoms
Outcomes
- Migraines decreased from 5+ episodes per month to fewer than 2 per month
- Anxiety and depression symptoms became more manageable with reduced daily intrusion
Fiscal Impact
$19,882 in estimated annual savings across migraine, anxiety, and depression management
Clinical Example
Juvenile Rheumatoid Arthritis & Uncontrolled Anxiety
17-year-old female
Patient was receiving infliximab infusions for her arthritis and was experiencing insufficient response to fluoxetine for anxiety. She was seeking alternatives, preferably oral.
Recommendations
- Recommended oral sulfasalazine, identified by DNA analysis as likely to achieve remission — avoiding the need for continued high-cost infusion therapy
- DNA results confirmed decreased response to fluoxetine and identified citalopram as a better-matched alternative
Outcomes
- Switch to citalopram led to significant improvement in anxiety — shifting from a meaningful daily burden to minimal impact
- Oral arthritis therapy option now available as an evidence-based alternative to infusions
Fiscal Impact
$38,580 estimated annual savings from transitioning away from infusion therapy
Beyond the Numbers
Benefits Not Captured in the Cost Analysis
The financial savings above are real — but they don't tell the whole story.
Improved employee health and quality of life
Increased productivity and fewer sick days
Reduced burden on family members and coworkers
Compounding savings in years two and three
Employee goodwill and benefit satisfaction
Reduced FMLA and short-term disability exposure
See What RxMapper Can Do for Your Plan
Every self-insured plan has members on the wrong medications. Let's find them — and fix it.