DecisionRx Inc. Pharmacist-Led Medication Optimization Associated With 19.4% Lower Medical Costs in a Medicare ACO Population

Savings Increased With Duration of Program Exposure, Reaching 31.9% ($462 Per Member Per Month) Following a  Nine-Month Implementation Window

INDIANAPOLIS, IN – September 15, 2026 (NEWMEDIAWIRE) – DecisionRx, Inc., a pharmacist-led medication optimization company, today announced findings from a new study of Medicare Accountable Care Organization (ACO) beneficiaries. The study found that when compared against matched controls, participation in the DecisionRx Medication Therapy Optimization (MTO) program was associated with a 19.4% reduction in total medical costs ($246 per member per month; p < 0.001). The intervention effect grew to 31.9% ($462 per member per month; p < 0.001) after 9 months of program exposure. Cost reductions were concentrated in acute and facility-based care.

Co-authored by DecisionRx executives in collaboration with researchers at the Johns Hopkins Bloomberg School of Public Health, the full study results, published online August 26, 2026 in Health Affairs Scholar, are available here. 

Medication-related problems, including adverse events and lack of therapeutic efficacy, are a persistent source of avoidable spending among Medicare beneficiaries, contributing to unnecessary emergency department visits, hospitalizations, and other medical utilization and morbidity. DecisionRx addresses this burden through an MTO model that 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.

The research draws on the Johns Hopkins ACG® System, a population-based risk assessment and predictive modeling platform, to evaluate how pharmacist-led medication optimization and pharmacogenomic testing affect utilization, prescribing patterns, medication-related outcomes, and cost across populations with varying morbidity burden and pharmacy complexity.

Using propensity score matching across 13 risk-adjustment metrics, researchers compared 1,003 treated patients to 14,031 matched controls, comprising 334,531 member-months of analytic exposure between October 2022 and September 2025. All 1,003 treated patients underwent pharmacogenomic testing using a simple at-home cheek swab to identify genetic markers that impact their ability to metabolize over 200 medications.  In the study, 91% of patients enrolled in the MTO program received at least one actionable pharmacist recommendation, 53% of patients exhibited lower polypharmacy risk one year after the intervention, and savings increased steadily over time in the program, reaching 31.9% after nine months of exposure. 

Compared with matched controls, MTO participation was associated with 43.1% fewer inpatient admissions, 41.3% fewer emergency department visits, and 28.3% fewer outpatient visits. Approximately one-third of pharmacist recommendations were informed by pharmacogenomic risk, while two-thirds addressed other medication-failure risk factors, including drug-drug interactions, drug-disease contraindications, therapeutic duplication, and probability of adverse events and side effects.

“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 new 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 formal validation of parallel trends combined with the pronounced dose-response pattern support a causal interpretation.

For more information, visit https://decisionrx.com/

About DecisionRx, Inc.

DecisionRx is a technology-enabled healthcare services company, improving patient outcomes and reducing healthcare costs by helping physicians optimize prescribing decisions for their patients. DecisionRx clinical pharmacists work on patients’ behalf to mitigate medication failure by making personalized medication recommendations to prescribers, informed by the latest clinical and data science, and delivered in a value-based care model. Medication failure accounts for at least 16% of total healthcare spending, and the DecisionRx medication therapy optimization (MTO) program has been shown to reduce total cost of care among polypharmacy patients by over 30%. 

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News Source: DecisionRx Inc.