With more powerful, expensive and potentially dangerous medicines reaching the market on a daily basis, the time has come to leverage genetic tests that provide physicians with the confidence that they have prescribed the precise drug and dose tailored to their patient's unique genetic code, a leading authority on personalized medicine at Medco Health Solutions, Inc told industry leaders.
"We are at the precipice of a revolution in personalized medicine," said Felix Frueh, Medco vice president of personalized medicine research and development. "With greater frequency genetic testing is recommended in the medication label. Making such tests the standard of care can significantly reduce waste, improve patient care and raise the safety profile for powerful new medications."
Genetic tests associated with prescription medications represent an additional up-front cost in the early treatment of a condition. However, a building body of evidence is showing that genetic screenings can lead to greater savings over time from fewer hospital admissions and less waste, Frueh said. He predicts that the use of pharmacogenomic testing will become increasingly popular over the next several years as clinicians, patients and payors seek more opportunities to improve safety and efficacy in pharmacy care.
Pharmacogenomics is the science of capturing a patient's genetic information to help predict how a person is likely to respond to a wide variety of drugs, including commonly used medications such as pain relievers, blood thinners and cancer drugs. This information has a bearing on what drug is selected and may help optimize doses for particular drugs.
Addressing attendees of an audio conference hosted by magazine publisher Atlantic Information Services, Inc, Frueh - who prior to leading Medco's pharmacogenomic research efforts led a core genomics review team at the US Food and Drug Administration (FDA) and chaired the first FDA-wide, interdisciplinary pharmacogenomics review group - said health care payors were an 'overlooked constituency' in the emerging field of personalized medicine, but the improved outcomes and potential savings make it extremely pertinent to their interests.
Frueh cited several examples where gene tests can reduce the costs of care, including cancer therapies, which can cost tens of thousands of dollars a month. For instance, a $500 test for the HER-2 gene could determine whether spending $50,000 a year for a specific breast cancer drug makes sense, since the drug does not work on two-thirds of patients who are Her-2 negative.
Cost savings aside, the clinical need for testing is paramount. For example, a genetic screening can help prevent the occurrence of potentially fatal hypersensitivity reactions, which can result from the use of a certain HIV medication (abacavir) and seizure medication (carbamazepine) in patients with a genetic pre-disposition.
Frueh identified 11 drugs that likely will be paired with genetic tests if and when they reach the market between now and mid-2010. These compounds include treatments for cancer, heart failure, HIV, COPD/asthma, Huntington's disease, Alzheimer's disease, and high cholesterol.
Medco and Personalized Medicine
Medco has existing research collaborations with Mayo Clinic studying genetic consideration in the use of warfarin, and with LabCorp for breast cancer patients using tamoxifen. Medco anticipates having the results of these studies available within the next year. The company also has a research partnership with the Food and Drug Administration aimed at improving patient health and the quality of the delivery of care via pharmacogenomics, and it anticipates additional development partnerships with other health care entities.
In addition, the Medco Personalized Medicine Programme offers solutions for payors to help enable them to leverage the potential advantages of personalized medicine by analyzing claims histories to identify patients who could benefit from genetic testing, communicating with physicians about testing options and results and engaging patients to educate them about genetic tests.
Medco Health Solutions is a leading health care company, serving the needs of more than 60 million people.