A recent study published in Health Affairs Scholar reveals that a pharmacist-led medication optimization program is associated with substantial reductions in medical costs for Medicare Accountable Care Organization (ACO) beneficiaries. The research, co-authored by DecisionRx executives and researchers at the Johns Hopkins Bloomberg School of Public Health, analyzed data from 1,003 treated patients and 14,031 matched controls over a three-year period from October 2022 to September 2025.
The study found that participation in DecisionRx's Medication Therapy Optimization (MTO) program was linked to a 19.4% reduction in total medical costs, equating to $246 per member per month (p < 0.001). After nine months of program exposure, the savings grew to 31.9%, or $462 per member per month. These cost reductions were primarily driven by decreases in acute and facility-based care, including 43.1% fewer inpatient admissions, 41.3% fewer emergency department visits, and 28.3% fewer outpatient visits compared to matched controls.
Medication-related problems, such as adverse events and lack of therapeutic efficacy, are a persistent source of avoidable spending among Medicare beneficiaries, leading to unnecessary emergency department visits and hospitalizations. DecisionRx addresses this burden through its MTO model, which combines data science, pharmacogenomic testing, and comprehensive review by clinical pharmacists. Pharmacists provide individualized recommendations to patients and prescribers, while prescribers retain final authority over all medication decisions.
All treated patients underwent pharmacogenomic testing using a simple at-home cheek swab to identify genetic markers affecting their ability to metabolize over 200 medications. The study showed that 91% of patients received at least one actionable pharmacist recommendation, and 53% exhibited lower polypharmacy risk one year after the intervention. Approximately one-third of pharmacist recommendations were informed by pharmacogenomic risk, while two-thirds addressed other medication-failure risk factors such as drug-drug interactions and therapeutic duplication.
"The most expensive medications are the ones that don’t work," said Travis Morgan, President and Co-founder of DecisionRx and co-author of the paper. "These findings strongly suggest that giving clinical pharmacists a central role in identifying medication-failure risk can help prescribers make more informed decisions and reduce costly medical utilization over time."
As a retrospective observational study, the analysis cannot definitively establish causation; however, the results showed high statistical significance (p < 0.001) and a dose-response pattern that supports a causal interpretation. The findings have significant implications for the healthcare industry, particularly for Medicare ACOs seeking to improve patient outcomes and reduce costs. By integrating pharmacist-led medication optimization and pharmacogenomic testing, providers can potentially avoid unnecessary medical utilization and improve quality of care. For more information, visit https://decisionrx.com/.
