Genetic testing and employer-sponsored wellness programs: An overview of current vendors, products, and practices

Abstract

Background: Employer-sponsored corporate wellness programs have spread despite limited evidence of effectiveness in improving health or reducing costs. Some programs have offered genetic testing as a benefit to employees, but little is known about this practice.

Methods: In December 2019, we conducted a systematic Google search to identify vendors offering corporate wellness programs involving genetics. We performed qualitative content analysis of publicly available information about the vendors' products and practices disclosed on their websites.

Results: Fifteen vendors were identified. Details regarding genetic testing offered within wellness programs were difficult to decipher from vendors' websites, including which specific products were included. No evidence was provided to support vendor claimed improvements in employer costs, employee health, and job performance. Only half offered health and genetic counseling services. Most vendors were ambiguous regarding data sharing. Disclaimer language was included in vendors' stated risks and limitations, ostensibly to avoid oversight and liability.

Conclusion: We found a lack of transparency among corporate wellness program vendors, underscoring challenges that stakeholders encounter when trying to assess (a) how such programs are using genetics, (b) the potential benefits of such applications, and (c) the adequacy of protections to ensure scientific evidence support any health claims and genetic nondiscrimination.

Keywords: ELSI; GINA; employees; population genetics; wellness.

Figure 1

Systematic search methodology is a funnel plot of the systematic search strategy used to identify (1) business‐to‐business vendors of, (2) corporate wellness programs, (3) offering genetic tests and/or services as part of the corporate wellness program.

Figure 2

Vendor marketing points of emphasis represents the marketing emphasis made on each of the vendors corporate wellness webpage. The “employer financial outcomes” bar represents the percentage of vendors that mentioned phrases such as “positive return on investment,” “reduce healthcare costs,” and “improved bottom‐line” on their corporate wellness page. The “employee health outcomes” bar represents the percentage of vendors that mentioned phrases alluding to overall health improvement for employees on the corporate wellness page such as “improve overall health” and “improved medical outcomes. The “employee job performance” bar represents the percentage of vendors that mentioned phrases like “improve employee productivity” on their corporate wellness page. The “employee behavior change” bar represents the percentage of vendors that stated phrases such as “employees exercise regularly” and “employees make healthier diet choices.” The “employee morale improvement” bar represents the percentage of vendors that alluded to changes in employee “stress levels,” “emotional health,” and “happiness” on their corporate wellness page. The “employee disease prevention” bar represents the percentage of vendors that alluded to their corporate wellness programs ability to “prevent disease,” to “identify high‐risk patients,” or to “decrease rates of illnesses” on their corporate wellness page. The “employee talent retention” bar represents the percentage of vendors that mentioned phrases such as “keep top talent” and “company loyalty” on their corporate wellness page. The “employee participation” bar represents the percentage of vendors that mentioned phrases such as “increased participation in wellness program” on the corporate wellness page. The values (n = x) within each bar represent the number of vendors that made each marketing point on their corporate wellness page. All the categories were coded independently; the percentages are calculated as the number of vendors that mention each marketing point (n = x)/total number of vendors identified (n = 15) × 100.

Figure 3

Variability in the type of genetic tests offered by vendors who also offer B2B corporate wellness programs illustrates the percentage of each type of genetic test across the vendors identified within the BTB corporate wellness market. A total of 71 genetic tests for all 15 vendors were identified. There are six insight categories: Nutrigenetics, fitness, traits & conditions, Pharmacogenomics, ancestry & familial, and pathogenic variants were determined. The values (n = x) within each bar represent the number of genetic testing products identified for each insight category. The percent of total row below the bar graph is calculated from n = x/the total number of tests identified in the market (n = 71) × 100.

Figure 4

Posttesting health and genetic consultations among vendors of B2B corporate wellness programs and their health‐related genetic testing products. (A) displays the relative percentage of all vendors that provide consultations with their genetic tests. The percentage of vendors providing professional health or genetic testing consultation was calculated from the total count of “Y” (n = 8)/total number of vendors identified (n = 15) × 100. (B) pie chart shows the percentage of all health‐related genetic testing products (n = 62) offered by BTB corporate wellness vendors that contained posttesting health or genetic consultation with a learned professional as a part of the product. The “pharmacogenomics consult” category represents the percentage of products that offered a consult with a health professional to discuss drug sensitivities and medication changes, and the “no consultation” category represents the number of products that did not mention any consultation with a health or genetic professional. The percentage values accompanying each category is calculated from the total number of tests for each category/the total number of health‐related genetic tests identified (62) *100. Data for each category of consultation were gathered independently.

Figure 5

Variability in posttesting health and genetic consultations offered by type of genetic test. The percentage of insights providing consultations with a learned professional was calculated independently for each insight. For example, if a single genetic test provides both Fitness and Nutrigenetics insight and offers a genetic or health consult a percentage point is added to both the Fitness and Nutrigenetics insights in the row titled “percent with genetic or health consultations.” N = x is total number of tests in each category. Each category was coded independently.

Figure 6

Variability in how genetic results are reported by vendors of B2B corporate wellness programs represents the method at which the genetic test results are reported to the user (either a consumer if as part of a DTC service or an employee or participating dependent if the test is provided as part of a corporate wellness program). All genetic tests (n = 71) offered by the BTB corporate wellness vendors were assessed to determine the method at which the user would receive their results. Five reporting categories were identified. The “paper report” category represents the percentage of all products that had the ability to mail results to the user and that mentioned the words “paper report” within the description. The “inquiry‐required” category represents the percentage of products that had no information about results reporting within their product description. The values (n = x) within each bar represent the number of genetic testing products identified for each reporting method. The percentages were calculated using n = x/total genetic testing products identified (n = 71) × 100.