{"id":7772,"date":"2010-02-05T16:51:47","date_gmt":"2010-02-05T16:51:47","guid":{"rendered":"http:\/\/euvolution.com\/futurist-transhuman-news-blog\/fda-warfarin-still-not-as-sexy-to-me\/"},"modified":"2010-02-05T16:51:47","modified_gmt":"2010-02-05T16:51:47","slug":"fda-warfarin-still-not-as-sexy-to-me","status":"publish","type":"post","link":"https:\/\/www.euvolution.com\/futurist-transhuman-news-blog\/genetic-medicine\/fda-warfarin-still-not-as-sexy-to-me.php","title":{"rendered":"FDA, Warfarin, still not as sexy to me."},"content":{"rendered":"

When everyone poo poo'd Warfarin, I became very, very upset. Here was a good clinical case for using PGx tests. Not a great case, but a good case. It was only when I began to think about feasability.<\/span><\/p>


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Lets face it, most decisions around starting coumadin happen in the hospital. Why?<\/span><\/div>

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Well, most patients receive an anticoagulation injection medication that most people have to be specially trained to administer at home versus a nurse in the hospital. Further, the rat poison known as coumadin is dangerous to take and is tricky to dose. So in the hospital is where a lot of people get titrated to the right dose.<\/span><\/div>

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This creates multiple problems<\/span><\/div>

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1. Insurers do not like paying for expensive meds like low molecular weight Heparin<\/span><\/div>
2. Insurers do not like paying for extra hopsital days to dose a medication<\/span><\/div>
3. Hospitals do not make any more money keeping people in the hospital to dose coumadin<\/span><\/div>
4. Doctors do like to keep patients safe<\/span><\/div>

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This creates a market opportunity with demand.<\/span><\/div>

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But the question remains \"Will testing get patients out of hospital quicker?\"<\/span><\/div>

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Maybe.<\/span><\/div>

<\/span><\/div>
Does this testing keep patients safer?<\/span><\/div>

<\/span><\/div>
Maybe.<\/span><\/div>

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Will the FDA change the label?<\/span><\/div>

<\/span><\/div>
They already did.<\/span><\/div>

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However, how many hospitals can run CYP2C9 and VKORC1?<\/span><\/div>

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Not very many.<\/span><\/div>

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What is the TAT?<\/span><\/div>

<\/span><\/div>
Unless it is 24 hours it will not be that helpful.<\/span><\/div>

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Now as a Hospital, what is the ROI?<\/span><\/div>
Now as a Insurer what is the ROI?<\/span><\/div>
Now as a physician what is the cost of interpretation?<\/span><\/div>

<\/span><\/div>
From a view point of a clinician who supports Personalized Medicine. We need to get rid of Coumadin and use Dabigatriban. <\/span><\/div>

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Is this testing useful? Yes. Is it clinically utilizable. If you are willing to wait a month.<\/span><\/div>

<\/span><\/div>
Will this get quicker? Yes.<\/span><\/div>

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How much quicker? 2 weeks quicker.....but the fact remains, unless you can get a TAT of 12-24 hours this is not a reality in most worlds.....<\/span><\/div>

<\/span><\/span><\/b><\/div>
The Sherpa Says: Great that the FDA notices the utility, but not great that the test is still too slow.<\/span><\/span><\/b><\/div>
\"\"<\/div>","protected":false},"excerpt":{"rendered":"

When everyone poo poo'd Warfarin, I became very, very upset. Here was a good clinical case for using PGx tests. Not a great case, but a good case. It was only when I began to think about feasability.Lets face it, … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"limit_modified_date":"","last_modified_date":"","_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[5],"tags":[],"class_list":["post-7772","post","type-post","status-publish","format-standard","hentry","category-genetic-medicine"],"modified_by":null,"_links":{"self":[{"href":"https:\/\/www.euvolution.com\/futurist-transhuman-news-blog\/wp-json\/wp\/v2\/posts\/7772"}],"collection":[{"href":"https:\/\/www.euvolution.com\/futurist-transhuman-news-blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.euvolution.com\/futurist-transhuman-news-blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.euvolution.com\/futurist-transhuman-news-blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.euvolution.com\/futurist-transhuman-news-blog\/wp-json\/wp\/v2\/comments?post=7772"}],"version-history":[{"count":0,"href":"https:\/\/www.euvolution.com\/futurist-transhuman-news-blog\/wp-json\/wp\/v2\/posts\/7772\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.euvolution.com\/futurist-transhuman-news-blog\/wp-json\/wp\/v2\/media?parent=7772"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.euvolution.com\/futurist-transhuman-news-blog\/wp-json\/wp\/v2\/categories?post=7772"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.euvolution.com\/futurist-transhuman-news-blog\/wp-json\/wp\/v2\/tags?post=7772"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}