Pharmacogenetics . Simplified

1. Pharmacogenetics . Simplified

2. How Effective are Medications?

3. How Can I Know What & How Much to Prescribe? Order a Pharmacogentics (PGx) test.

4. Who is Already Using (or teaching) PGx Testing? • Harvard Medical School & Beth Israel Deaconess • Vanderbilt • Georgetown Medical School • Stanford University - Center for Genomics and Personalized Medicine • Scripps-Howard • Columbia Presbyterian • Weill Cornell Precision Medical Institute • NIH & FDA • Drug Manufactures – Tailored Therapeutics • Cardiology & Anesthesiology Boards

5. Benefits of PGx Testing Right Drug at the Right Dose for the Right Patient for the First Time! • Precision prescribing is better medicine than “Trial and Error Prescribing.” • Decrease ADE’s (adverse drug events) • Less hospitalizations as a result of ADE’s • Healthcare cost savings

6. What is Pharmacogenetics (PGx)? It is the study of Genetic Differences in Metabolic Pathways which can affect Individual Responses to drugs, both in terms of therapeutic affect as well as adverse effects (how genetics influence a patient’s response to medications).

7. What is Pharmacogenetics (PGx)? • Genes affect Patient Drug Metabolism and Response • Predict in Advance = Better Medicine/Outcomes • Genomic Differences • Influence Efficacy – Therapeutic Window • Increase Risk of serious Drug Side Effects • Increase risk of Drug-Drug Interaction

8. Personalized Medicine Adds Precision to Prescribing • Tailoring Medical Treatment to Individual Patient • Sophisticated Molecular Tools • Better Outcomes with Fewer Adverse Events • Personal Medicine is a shift from what works for a “typical” patient to what works for the “Individual” patient. • Right Drug for the Right Patient at the Right Dose

9. The Future is PGx Testing “The point of personalized medicine is to develop better efficacy, better outcomes, fewer adverse affects and lower systemic costs.” Dr. Edward Abrahams Personalized Medicine Coalition – The Boston Globe January 25, 2010

10. Why Utilize PGx Testing? • Identify likelihood of Adverse Drug Event (ADE) • 25-50%have polymorphism • 2.2 Million ADE’s occur annually with 106,000 deaths • Increase Drug Efficacy • Only 58% of Pain Management Patients receive Relief • Cardiac patients with Reduced Function Alleles have 3.5 – 8 times greater risk for major CV Event • 30% of Psychiatric disorders have severe ADE’s • 50% of Urology drugs have No Therapeutic Affect • Increase Patient Compliance and Retention • Standard of Care – Specialty Boards • Market Practice, Mitigate Risk, Reduce Healthcare Costs

11. PGx Dynamics

12. Patient’s Genetic Profile

13. Reports:Simple & Informative

14. Cardiac & Pain Panels

15. Psychiatric & Urology Panels UROLOGYMEDICATION PSYCHIATRIC MEDICATION

16. Tailored Therapeutics “The power in tailored therapeutics is for us to say more clearly to payers, providers, and patients – ‘this drug is not for everyone, but it is for you.’ That is exceedingly powerful.” John C. Lechleiter, Ph.D President and Chief Executive Officer, Eli Lilly and Company

17. Goals “Today, one of our biggest goals is to cut the cost of sequencing an entire human genome to $1,000 or less. This advance will pave the way for each person’s genome to be sequenced as part of the standard of care, leading to a revolution in the practice of medicine.” Francis S. Collins, M.D., Ph.D. Director, National Institute of Health

18. Implement PGx in Your Practice • Buccal Swabs - Simple, Non-invasive, Quick, Convenient • No Costs - Test Kit & On-site Pickup free to practice • Clinically Actionable Results – Easy to Read & Electronically Delivered • Insurance Paid – Covered by Medicare & most major Commercial Payers • New Revenue Source - Physician Reimbursed for Interpretation • Pharm-D - Available for Consultation

19. Pharmacogenetics . Simplified Richard G. Orchard916.759.7883rorchard@vantagerx.com