The Acquisition by Medco What does DNA Direct bring to Medco? PHELAN. Medco’s healthcare clients, whether they are large self-insured employers or health plans, are all looking for better patient outcomes and quality of service, as well as reduced costs. DNA Direct helps with the interpretation of genetic information and to make it actionable. Medco’s research shows there is a gap in physician understanding of genetic tests. Medco’s healthcare clients have tremendous interest in this area of pharmacogenomics. The Payer Connection How can payers benefit from genetic testing? PHELAN. Payers are looking at utilization management and clinical programs, and for healthcare plans it’s much broader than just pharmacogenomics. The field of utilization management is using molecular genetics to look at what health plans are actually paying for and whether patients are getting the full value of diagnostic testing. Genetic testing can help plans with their clinical policy and guidelines around these diagnostics. Molecular diagnostics can help plans to determine a treatment approach and they can be used to determine if a particular patient will respond to a particular treatment or drug. Genomics can help identify those who are at risk, who are carriers of a genetic mutation, and who can benefit from early diagnosis. There is a range of information that can come out of a test. Growing Physician Knowledge How can genetic testing move personalized medicine forward? PHELAN. People have been talking about personalized medicine for years now. I think we’re ready to see the translation of this early science into clinical practice. It’s so important for physicians to learn more about this area of pharmacogenomics. As an example, we recently did a Webinar for providers on the KRAS mutation. The prescribing pattern around colorectal cancer has changed with the advent of the KRAS mutation testing. Physicians who would have prescribed Erbitux or Vectibix before are now trying to identify, based on patients’ mutation, whether they are going to use that drug for particular patients. We are working to help physicians understand when a test is useful and how genetics will impact dosage for a particular patient. We are helping to translate the scientific understanding around genetics testing, and integrate it into healthcare sooner rather than later. Some studies say it often takes 17 years for a technology to get integrated into healthcare practice. We can help inform physicians through Webinars, continuing medical education, and decision support tools that allow a physician or patient to learn in an interactive way about the impact of a particular diagnostic. We can also provide support services to physicians or patients about what that test result means to them and how will they make that information actionable. F PharmaVOICE welcomes comments about this article. Email us at [email protected]. Physicians who feel well-informed about genetic testing or have had previous pharmacogenomics (PGx) training are far more likely to have ordered these tests or recommended them to their patients. But there is little formal PGx education available to physicians, according to a research survey by Medco Health Solutions. According to the survey, only slightly more than one in four physicians had any type of PGx training in either their graduate or postgraduate schooling and only 10% believed they were adequately informed about PGx tests. Other findings: • 98% of physicians agree that patient genetic profiles may influence drug therapy but only 10% believe they are adequately informed about PGx testing. • With regard to physician adoption, only 13% of respondents had ordered or recommended a PGx test in the previous six months while more than one quarter of those polled (26%) planned to do so within the next six months. • Only 26% of physicians had some form of either medical school or postgraduate PGx education, but those who said they were well-informed about PGx tests were twice as likely to order or recommend them as those who were not. • Physicians who have ordered PGx tests tended to be older males out of medical school for 15 to 29 years, oncologists, and had prior PGx education. Source: Medco Health Solutions. For more information, visit medcoresearch.com. Some studies say it often takes 17 years for a technology to get integrated into healthcare practice. yan Phelan is Founder and CEO of DNA Direct, which provides clinical programs that combine proprietary technology with genetic expertise including a national call center of genetic experts, Web-based applications, and educational resources and training. The company was acquired by Medco Health Solutions in February. The DNA Direct purchase builds upon Medco’s commitment to advancing pharmacogenomics, a cornerstone of which is the company’s Personalized Medicine Research Center. The research center is dedicated to furthering the understanding of the impact of genetics on patient medication response and applying that science to clinical practice. DNA Direct’s Ryan Phelan talks about how providers are using genetic testing. Ryan Phelan is founder and CEO of DNA Direct, a company that provides guidance and decision support for genetics to consumers, healthcare plans, healthcare providers, and laboratories. In February, DNA Direct was acquired by Medco Health Solutions. Ms. Phelan has been a consumer health advocate for the past 25 years, having started the first medical library for consumers in 1978. As founding director of Planetree, a nonprofit consumer healthcare organization, she helped create a national model for humanizing hospitals and a national model for providing health information to the public, the Planetree Resource Center. In 1995, she founded Direct Medical Knowledge (DMK), a consumer health Web site. DMK developed proprietary software that enabled users to drill down through the most current medical literature and retrieve personalized health and medical information. In 1999, DMK was acquired by WebMD. DMK’s content became the backbone of WebMD’s consumer health site, my.webmd.com. 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