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Letter from the Editor #496

Nov 19, 2009

I was reading a pharmacy journal last week and was surprised to find that Medco Health Solutions, the pharmacy benefit manager, was going to study how the genetic makeup of patients affects the efficacy of drugs. It seemed a little odd that a benefits manger was going to enroll 14,000 patients in the study. As I began to dig deeper I found the reason. There is a problem for patients who have normal functioning versions of the gene CYP2C19 as they appear to be extensive “metabolizers of Plavix (clopidogrel).” This means that these ACU patients would get a better benefit from Effient (prasugrel). You might ask why Medco want to spend all that money to do the study, but it is not too hard to understand when you think about the fact that Effient will cost more and Plavix will be going generic in 2011. Simply put if Medco can show that Plavix (clopidogrel) works as well in these patients then they will save a giant bucket of money.


Some of you may be able to remember back to the phrase “a little dab’ll do ya” and others can still see the almond growers who asked us to “only eat 2 cans a week”. They were trying to get us to just use their products a little, and now Sheri Colberg-Ochs, Ph.D., FACSM has applied this concept to physical activity. This week in her feature, How Little Physical Activity It Takes to Have a Big Impact, she shares results from some trials that she and others did with older patients. 




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Dave Joffe, Editor-in-chief