TalkWarfarin DNA Test in the News
The Washington Post has an unusually lengthly article on DNA testing to determine warfarin dosing. Recently, I blogged about the launch of this testing: “Warfarin Sensitivity Test Launches.”
Warfarin (brand name Coumadin) is a popular blood-thinning medication used by about 2 million Americans. It’s prescribed after surgeries, strokes, blood clots, and to prevent blood clots. Medco Health Solutions and the Mayo Clinic are collaborating on a project using this testing to determine initial dosing for patients.
Epstein and other experts say the warfarin projects comprise the first broad use of personalized medicine, or targeted therapy, in which a person’s genetic makeup is used to pick the best medicine or dose. This approach essentially adjusts for differences in body chemistry that explain why one pain reliever or allergy pill works great for you but not for your mom. …
If the warfarin studies are successful, patients will start demanding personalized medicine, he predicted. Insurers will, too, if the Medco study proves it saves money and protects patients.
That’s fairly likely, given Medco data showing that if patients have their warfarin dose changed more than once _ meaning doctors didn’t get it right the first two tries _ their risk of being hospitalized for complications jumps from 20 percent to 31 percent.
[Dr. Robert] Epstein [CMO of Medco] said he’s hit “a home run” with his pitch to get employers and insurance companies sponsoring the prescription plans to join the study. “Everyone we’ve talked to unanimously was in,” said Epstein, who expects the reduction in medical costs will be triple the test price of a few hundred dollars per patient.
When - and I say when, not if - hospitals and insurers see the bottom line benefits of personalized medicine, you can bet we’ll see CYP450 and similar DNA testing entering everyday medical practice. I just hope that these changes will happen quickly in an industry reknowned for moving slo-o-wly.
Technorati Tags: warfarin, coumadin, sensitivity, dna testing, medco, mayo clinic, personalized medicine,
January 13th, 2007 at 11:55 am
I’m so interested in CYP450 testing. Don’t you want to write a post on the subject? There must be some improvements…
January 16th, 2007 at 5:24 pm
Hi NCurse, glad to hear you’re also interested in CYP450s. Recently, I’ve been posting about CYP450s and individual drugs (or substrates), for which testing seems to be clinically useful, since my personal interest is of the “it’s cool, but what can we do with it now” nature. But tell me more about what you mean by “there must be some improvements”? As a medical student interested in genetics, you’ve got a unique perspective, with insights into both the science and the application.
January 19th, 2007 at 9:57 am
I wanted to hear about a complete CYP450 test, but I’m too optimistic. Pharmacogenomics is not so close to us now. I’ve only found one improvement: Depression, CYP450 Testing for Adults Treated with SSRIs… But I’m still searching.
January 19th, 2007 at 12:04 pm
I think we’re pretty far away from having a “complete P450″ test available, whether within the research community or commercially. But I’m optimistic we’ll get there eventually. For now, commercial testing is available for the major P450s — 2D6, 2C9, 2C19. And there’s only one FDA-approved test kit, but I think soon we’ll see more. The big question as I see it is not the testing itself, but establishing the utility of the tests.
February 23rd, 2007 at 2:37 pm
I understand that Osmetech are about to receive FDA approval anytime now for CYP450 warfarin test.
August 18th, 2007 at 8:25 pm
I would be so happy for my Mom to have dna testing for her drug therapy, sinse she is on about twenty perscriptions encluding warfarin and I have to take her for blood tests at least every two to three weeks to keep it regulated.