S3E1 – Impacting Mental Health Through Pharmacogenomics with Scott Megill

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Jenn Dellwo: Welcome back for a new season of RadioRev. I’m Jenn Dellwo. Thank you for joining us for season three. This series of episodes focuses on silver linings and new innovations in healthcare. We’ve experienced a lot of uncertainty and change over the last 15 months, catapulting the industry into a reality where creativity and bright spots have unexpectedly emerged as a result of the pandemic. So this season really is about focusing on the bright spots—the innovations and the positive outcomes—highlighting the member stories that don’t often get heard. Today, we’re joined by Scott Megill, President and CEO at Coriell Life Sciences. Welcome to the show. Thanks so much for being here.

Scott Megill: Thanks for having me, Jenn.

Jenn Dellwo: So we’re going to dive right in. Let’s start with some background. Tell us about yourself and how you ended up leading the team at Coriell Life Sciences.

Scott Megill: Well, I found myself at the Coriell Institute for Medical Research, which is a nonprofit in New Jersey, actually running their Information Technology and Bioinformatics Group after an acquisition of the company that I was working for, which was Rohm and Haas by Dow Chemical. So my background is really in lots of different industries, focused mostly on how to apply technology to business. But once I started at the Institute, at the Coriell Institute, there was an obvious opportunity there to create a commercialized version of some research that was happening there, focused on utilizing genetic information in the clinic. And so we spun out Coriell Life Sciences to do exactly that. My background is really in technology and then applying technology to business, and there really is no better place to do that today than healthcare.

Jenn Dellwo: Absolutely. So let’s talk a little bit more about Coriell Life Sciences. Can you tell us more about the organization and the work that you do?

Scott Megill: Yeah. So, as I mentioned, the company was a spin out from a nonprofit. The nonprofit has been around since 1953. We started Coriell Life Sciences in 2013, really taking some intellectual property that had been created through a research study there that was looking at how we can use genetics in a meaningful way. One of those areas is in medication management. And so what we did was to spin out a commercial organization and focus on how we could build tools and technologies that could bridge the gap between what was happening in the laboratory with genetics and how doctors could actually make use of it. The company is really focused on how we do that at population scale. So, not only helping individuals, but helping systems to implement these kinds of tools and technologies in a way that’s meaningful.

Jenn Dellwo: You’re leading right into my next question. So from a partnership perspective, how do you work with other healthcare organizations to influence health outcomes?

Scott Megill: In healthcare, nothing happens in isolation. It’s such an integrated and kind of connected set of services that have to be provided through payers and information technology and the regulatory environment—and of course, the care providers themselves. In order to have anything new emerge in healthcare, it really needs to be integrated at all levels. So, we work with payers, whether that be insurance companies or self-insured employers, public sector entities, government agencies—groups that are ultimately on the hook economically for the healthcare of the constituents they serve. But we also work with the implementers like pharmacy benefit management companies, laboratories, and pharmacists, to ensure that the tools and technology that we promote are really integrated into the standard workflow of clinical delivery. And that really is very challenging. It’s actually—that’s far harder than the science. So for us, it’s about building those bridges using channels of delivery that already exist.

Jenn Dellwo: So, moving on to talk about the people that you serve, I’d like to talk a little bit about personalization in healthcare. How is Coriell Life Sciences impacting people on an individual level?

Scott Megill: Fundamentally what we’re doing is bringing a new facet of insight about individual patients to clinicians so that we can make better choices when it comes to medications. As it turns out—we probably all know this—but drugs don’t work for everybody. The same pill taken in the same dose by two different people can have wildly different results. For one person, it could be safe and effective. For another, it could be ineffective. For someone else, it could actually cause them harm. A lot of that is actually because of variations in our genome. Our DNA itself controls the rate at which a lot of these medications are processed by our bodies. And that’s something that typically has been hidden from clinicians when they prescribe medications. Back in 2003, we mapped the human genome for the first time. As a species, we mapped the human genome for the first time, and now have the ability to measure those variations in a very quantitative and reliable way. So, we can make very well-founded predictions as to how someone will respond to medications based on those variations. So what that really means is a simple test: You can rub a Q-Tip on the inside of your cheek or spit in a tube, and that biological sample could be sent off to a laboratory and then interpreted by a company like Coriell Life Sciences to very discreetly tell a doctor, “Don’t put this person on this pill. It’s not going to work for them, or it’s not going to be safe for them. Use this one instead.” So at the individual level, that’s really where we focus our attention: How do we get people to avoid that journey to try to find the right medications by telling them exactly where to go instead. And that obviously has tremendous impact on both the person themselves, the patient, but also the healthcare system that’s taking on the economic burden of getting pills wrong.

Jenn Dellwo: And I would imagine, as you’re speaking about this individual level of care, are you hearing any member stories that stand out to you that you can share with us?

Scott Megill: That’s been the really gratifying thing about this job and this company: What we receive back most often is the feedback from patients directly. And a lot of who we work with are the people that are taking the most pills. That tends to be elder patients. So we hear stories about elder patients that are able to get out of bed for the first time in a year or play with the grandkids again, starting to feel normal again. And a lot of it is really about hope. You know, when we reach a certain age and we have this kind of downward spiral of medications that just get piled one on top of another, you tend to lose hope that you’re ever going to feel better again. And so what we’re really able to do is rationalize that medication treatment plan in a way that people do start to feel better, and they do start to have hope again. And a lot of that comes down to—what’s kind of unique about our approach is it’s not just about a laboratory test. This isn’t just, let’s go get your genome sequenced. This is about how we introduce that new information into a pharmacy consulting service that looks at everything about that medication plan. So, it’s not just the genetics. It’s how do those drugs interact with each other? How they interact with the foods that you eat, the things you drink, the things you smoke, the conditions you’re suffering, all then taken into account to come up with what is ultimately a recommendation for the right plan for the right patient delivered to their own doctor. So, it’s been really very gratifying, as I said.

Jenn Dellwo: Yeah, I can imagine, hearing those stories. That has to feel good. You know, as you’re talking about hope, I think we all saw, and many of us felt, the impact of the pandemic on mental health—our families, friends, coworkers, and in many cases, ourselves. The work you’re doing is clearly a bright spot. But can you talk more about how pharmacogenomics improves mental health treatment?

Scott Megill: Predating the pandemic by quite a bit coincidentally, pharmacogenomics is one of the major factors for the drugs that are typically used to treat depression, anxiety, PTSD, and ADHD. It just so happens that the importance of this is now merged with so much more of a spotlight because of the pandemic. So, there’s no doubt that mood disorders/mental health is going to be a very serious and very acute issue over the next few years as we emerge from the pandemic. Pharmacogenomic testing can help to avoid the journey that individual patients have to go on to find the right treatment at the right dose by eliminating medications that just simply aren’t going to work. So often a pill will be tried, and we don’t know for six or eight weeks whether or not it’s having an effect. Typically, mental health is something you can’t measure quantitatively. We have to do trending, and we have to analyze how is that person feeling over a period of time. But if we know right up front that, hey, we should avoid pill A, it’s just not going to work, well, we’ve just saved that patient six or eight weeks of continuing to suffer from that condition. So, it is something that we’re very focused on in helping systems to deliver this kind of better care for patients that are suffering this way, whether it be pandemic related or not.

Jenn Dellwo: Excellent. With the year we’ve just had, after all of the change and uncertainty, what’s something that makes you feel optimistic?

Scott Megill: Well, certainly we’re seeing an awful lot more acceptance of testing in general that’s happening because of the pandemic. We’ve had an awful lot of barriers knocked down by both the regulatory environment and just pure logistics in ensuring that the laboratories themselves are available and that they can provide the kind of care that they give at a broad and scalable volume. So for me, when I look at what makes me hopeful or optimistic in the future, I think it’s really about the availability and the acceptance of genetic testing and this sort of testing in the future. I think we’re really at a stage now where people maybe 10 years ago looked at genetics as maybe a scary thing. But I think there really has been a dramatic shift in that. I think we’re all as a culture much more medically curious about our own health and tracking all of the things that we can track about our own health. And all of that, I think leads very naturally into understanding how your genetic makeup impacts those things you put in your body.

Jenn Dellwo: What’s something positive that’s come out of COVID-19 for you or for healthcare that should never go back to the way that it was before?

Scott Megill: Well, piggybacking a little bit off of what I was just discussing with labs. Now we have a capacity out there that is certainly a capacity to test in a way that just wasn’t there pre-pandemic. All of these laboratories that thankfully jumped on COVID testing—the equipment that they had to buy in order to do that, the scaling that they had to do in order to accommodate those volumes—all of that needs to be repurposed post-pandemic. We’re already doing a lot less COVID testing than we once were. So in order to really understand how they’re going to maintain the financial burden that they took on to buy this equipment in the first place, they have to look for new reasons to use those machines. The same machines that test for COVID are very often the same machines that can do genetic testing, pharmacogenomic testing, and so forth. So, I’m extremely hopeful that we’re going to see just the availability of this sort of testing and the price point drop. It’s already quite inexpensive, but it would be really nice if it was just something we don’t even think about, that this is tens of dollars. Everybody should have a genetic test done. This is an artifact of your patient record that should live with you for the rest of your life. Your genes don’t change, so you don’t have to get tested over and over again. Let’s have this information available for all patients. Let’s have it there for the entirety of their healthcare.

Jenn Dellwo: That’s the dream right there. Well, Scott, thank you so much. If people would like to connect with you or learn more about Coriell Life Sciences, what’s the best way to get in touch?

Scott Megill: Our website is www.coriell.com. And I’m certainly always available via LinkedIn. This is probably the best way to get ahold of me. So my profile is out there in the public.

Jenn Dellwo: Excellent. Thanks, Scott.

Scott Megill: Thank you, Jenn.

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