Pharmacogenomics in aisle 1?
Not quite, but the continued evolution of Kerr Drug’s Community Healthcare Center store concept certainly offers a glimpse into what role community pharmacy could play in the American healthcare system of the future—and it goes far beyond just medication therapy management. Like the deal CVS Caremark announced in November with Generation Health, pharmacogenomics, the study of how genetics influence drug response, represents the new frontier of community pharmacy. And it’s a brave new world out there, to be sure.
In fairness, pharmacogenomics has been a part of the specialty pharmacy business for some time. But projects like Kerr’s pilot with the University of North Carolina’s Eshelman School of Pharmacy, which will focus on patients taking Plavix, target the long-term savings generated by patients on traditional drug therapies (see related story). These types of programs will be instrumental in demonstrating community pharmacy’s value beyond simply dispensing; the idea that a $250 test performed at the local drug store potentially could save $50,000 or more in upstream costs.
“We are at the doorstep not only of a new store, but also the future of community pharmacy,” Kerr Drug president and CEO Tony Civello told guests at the grand opening.
At the same time, on a much larger scale, the CVS Caremark-Generation Health deal will give big healthcare payers a front-row seat as it demonstrates the value of pharmacogenomics, offering PBM customers a chance to offer testing programs around drugs used to treat cancer, HIV and heart disease (see related story). CVS actually took a minority position in the privately held company, and chief medical officer Troyen Brennan will serve on Generation’s board of directors. So you can say the folks in Woonsocket hold quite a bit of stock in this whole area of personalized medicine.
That CVS is showing its leadership in an area like pharmacogenomics is not surprising. It is a company that has invested considerably in recent years to build a future beyond simply dispensing pharmaceuticals. But stories like what Kerr is doing in examination room No. 5 in its new Community Healthcare Center are an important reminder of the innovation and leadership that continues to come out of Chapel Hill, N.C.
They also are a sign that maybe the future of pharmacy doesn’t have one of those “you must be this size to ride this ride” signs. It’s not that size isn’t important, so much as maybe there is more than one way to measure it. Maybe, big ideas count, too.
CDC director: About 16% of Americans have been sick with H1N1 this year
ATLANTA One-in-6 Americans have been sick with the novel H1N1 virus so far this year, Thomas Frieden, director of the Centers for Disease Control and Prevention, reported during a news conference Thursday.
“We estimate there have been nearly 50 million cases, mostly in younger adults and children,” he said.
That includes approximately 200,000 hospitalizations so far this year, which correlates with the number of hospitalizations typical for the seasonal flu. However, there have been almost 10,000 deaths, including 1,100 children and 7,500 young adults, Frieden said. “That’s much higher than in a usual flu season,” he said. So as we’ve seen for months this is a flu that is much harder on younger people and fortunately has largely spared the elderly until now.”
And though the number of H1N1 cases is expected to continue to decline this week, Frieden cautioned against complacency, commenting that the typical flu season extends into May and noting that the vast majority of Americans — 5-in-6 — have not become sick with H1N1, suggesting there is still a significant number of people who could become ill.
While the number of H1N1 cases decline, the amount of H1N1 influenza vaccine available continues to increase — approximately 85 million doses have been delivered to the CDC to date.
“Many states have increased the eligibility, having met the demand in the five priority groups to the general population and that’s consistent with the recommendations of the Advisory Committee on Immunization Practices,” Frieden said. “This is still a good window of opportunity to be vaccinated. I can certainly understand that many people might [ask], ‘Well there’s been so much disease and it’s going down so much, why get vaccinated now?’ But the fact is we don’t know what the future will hold.”
PricewaterhouseCoopers: Personalized medicine market to grow 11% annually
NEW YORK PricewaterhouseCoopers’ report that the personalized medicine market will grow 11% per year is just another indication that the field could become the next generation of community pharmacy.
A lot of research already has gone into studying the interactions between drugs and the genetic makeup of the patients who take them. In October, pharmacy benefit manager Medco Health Solutions announced that it would undertake a study to determine whether the presence of a normally functioning version of the gene CYP2C19 in 70% to 75% of patients, which makes them “extensive metabolizers” of Bristol-Myers Squibb’s and Sanofi-Aventis’ anticlotting drug Plavix (clopidogrel), have comparable outcomes to patients taking Eli Lilly & Co.’s Effient (prasugrel). Unlike Plavix, metabolism of Effient does not depend on patients’ genetic makeup.
Meanwhile, CVS Caremark will work with Generation Health to expand pharmacogenomic, or PGx testing to its pharmacy benefit manager clients to predict how patients will respond to medications for cancer, cardiovascular diseases and HIV. CVS expects to introduce PGx clinical services to its PBM clients in second quarter 2010. Regional chain Kerr Drug, working with the University of North Carolina’s Eshelman School of Pharmacy, will begin targeting patients using Plavix in a PGx program of its own by using DNA testing to optimize the therapeutic effects of the drug at its new Community Healthcare Center in Chapel Hill, N.C.