Shawnee County reviews TRIA Health annual report and weight-management carveout to curb rising drug costs

Shawnee County commissioners heard TRIA Healths annual report on pharmacy advocacy, remote monitoring and a proposed weight-management medication carveout at a morning work session. TRIA said clinical interventions reduced risk for high-cost events and produced measurable plan savings in 2025, while county officials asked how any changes would affect employee costs.

Katie McGilly, senior account manager with TRIA Health, said the firm had 159 Shawnee County members actively engaged with a TRIA clinical pharmacist at the end of the 2025 reporting period, up from 136 at the end of 2024. "We had 159 members engaged and actively working with one of our clinical pharmacists," McGilly said, and cited a patient example in which medication optimization reduced a members A1C from above 10 to about 7.1 and avoided an outpatient visit.

TRIA presented program metrics and clinical findings: about half of engaged members have three or more chronic conditions; the top conditions were high blood pressure, high cholesterol, mental health and pain; among remote-monitoring participants, TRIA reported average A1C under 7.0 for diabetes-monitoring users and an average A1C reduction around 2.39% for that subgroup. For blood-pressure monitoring, TRIA reported four users with a 10 mmHg systolic reduction and 26 pharmacist interventions during the year.

On finances, McGilly said TRIA validated a strong return on investment: TRIA reported an overall 8:1 ROI for clinical programs and said prescription-savings alone produced a 2.6:1 ROI in the 2025 review. TRIA explained it credits only validated avoided visits (using a 90-day rule after clinical recommendations) when calculating health-care avoidance savings.

January Pointer, TRIAs product engagement executive, outlined a weight-management offering that pairs a health coach with a pharmacist and includes a welcome kit (cellular body-composition scale, portion plate, water bottle, tape measure and the TRIA app). Pointer said the program aims to support members using anti-obesity GLP-1 medications by monitoring side effects, protecting clinical appropriateness and helping members sustain behavior changes.

Pointer presented modeling of a medication carveout tied to program participation. Using 2025 claims data, TRIA identified 130 members who filled two high-cost medications referenced in the presentation (transcripted as "Zetbound" and "WGO"). Pointer said a direct-to-employer pricing model could lower 30-day fill prices in TRIAs scenarios and that requiring program participation for access to discounted pricing typically lowers utilization by about 35%, TRIAs modeling shows.

Commissioners questioned whether the plans savings would simply shift costs to employees. Commissioner Kevin Cook said he was concerned members could see higher out-of-pocket costs, noting the trade-off between plan savings and employee affordability. Pointer and TRIA staff said the employer can design the member cost share several ways: keep the existing $35 copay, use a co-insurance option, set a flat employer contribution, or change the copay; TRIA emphasized these choices are customizable and not mandatory.

TRIA also described targeted pharmacogenomic (PGX) testing (a mailed cheek-swab DNA test) for the highest-risk engaged members and explained its process for transmitting recommendations to prescribing physicians. TRIA said physician partners accept its recommendations at a high rate in the companys book-of-business statistics and that TRIA uses a 90-day verification window before counting discontinued drugs as realized plan savings.

Angela Lewis, Shawnee Countys director of administrative services, told commissioners that any plan design change would first go to the insurance committee and, if recommended, return to the commission for a formal recommendation and next steps.

What happens next: no committee votes were taken at the session. TRIAs presentation will be considered by the insurance committee and any recommended changes would come back to the commission for approval and implementation decisions.