Medco amps up personalized medicine program

The FDA advises, but Medco Health Solutions activates. The pharmacy benefits manager is urging doctors to screen patients before prescribing certain drugs, including the blood thinner warfarin and breast cancer med tamoxifen. The "personalized medicine" move is designed to target prescriptions to patients who really will benefit from them, saving money and improving healthcare in the process.

There are scores of medications that work in only a fraction of patients. Take the cancer meds Vectibix (Amgen) and Erbitux (Bristol-Myers Squibb). They simply don't work in the 40 percent of patients with a mutation in the K-Ras gene. Amgen itself went to FDA to beg for labeling that would require diagnostic testing before the drugs were administered. At $8,400 a month for Vectibix, narrowing the use to only those patients who can really benefit could save lots of money.

This move toward personalized drug therapy has been afoot for some time, but the world sometimes moves a lot slower than the science does. But Medco has compelling reasons for pushing it: For one thing, it now owns a company that makes genetic tests. More usage equals more revenue. And more usage equals more money saved for its clients, which keeps employers in the Medco fold.

Medco has signed up 200 employers for the genetic-screening program. The company aims to expand it not only to more employers, but also to more drugs, such as the blockbuster blood-thinner Plavix, which works best in patients without mutations of a certain gene. No doubt even more genetic testing will soon follow, for competitive reasons: Rival CVS plans to roll out its own personalized-medicine service later this year.

- read the Bloomberg story