Tailoring Treatments To Patients' Genetics

Since it turns out that genes play a big role in how an individual responds to certain drugs, the pharmaceutical industry is looking at genetics. Entrepreneurs are developing and marketing products to try to determine whether a particular drug will work for a patient.

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Now, among biotechnology companies there's another trend. Drug companies and entrepreneurs are beginning to develop and market products tailored specifically to the genetic makeup of individual patients. They look at your DNA and come up with a product that works just for you. The idea is to make treatments and dosages more precise and effective. From Seattle, NPR's Wendy Kaufman reports.

WENDY KAUFMAN: Scientist Rishma Joshi(ph) is on the front line in a new approach toward medicine and healthcare, one based on a patient's genetic makeup. Seated at a lab bench at Iverson Genetics Diagnostics, Joshi pulls on purple latex gloves and begins to transfer blood samples into test tubes in preparation for analyzing a patient's DNA.

Dr. RISHMA JOSHI (Iverson Genetics Diagnostics): We need to get the DNA from the nucleus, so we are breaking open the cell and getting the DNA to float out. And then we're going to spec it and then we run it on different analysis - different genetic analysis.

(Soundbite of machine)

KAUFMAN: The goal of this particular test is to determine what dose of a potent and widely prescribed anticoagulant, known as warfarin, a patient should get. Because of their genetic makeup, individuals metabolize the drug differently. And if they get too much of the drug for their body they could bleed internally, too little and they could suffer a stroke. Some two million new prescriptions of the drug are issued each year. And initially doctors often have a hard time prescribing the ideal amount. But as Dean Sproles, founder and CEO of Iverson, explains, with DNA testing that should become much easier.

Mr. DEAN SPROLES (CEO, Iverson Genetics Diagnostics): We can read the results, report the results back to your physician, and the physician is then able to prescribe the accurate dose for warfarin.

KAUFMAN: Iverson is just one of several companies working on warfarin dosing. Genetic tests have been developed for other drugs as well, including cancer and AIDS drugs. Some medications, including warfarin, must now carry labels recommending genetic testing. And testing is required before women are given Herceptin for breast cancer.

Health economist Mark Pauley of the University of Pennsylvania's Wharton School says the ability to figure out if a drug will work for someone and at what dose couldn't have come at a better time.

Professor MARK PAULEY (University of Pennsylvania Wharton School): In a way, the timing is good, because the pace of discovery of new drug products has really dropped off quite substantially. So discovering something useful would actually be good news for the health care sector as a whole now.

KAUFMAN: But as with many breakthroughs, this one has a potentially dark side. Insurers might try to use the genetic information to increase an individual's premium or deny coverage altogether. Wharton's Pauley also worries that once the drug companies can figure out who will benefit from a drug, they might raise the price, saying in essence we both know this drug will work for you, so you'll have to pay more.

Still, genetic testing of this sort holds tremendous promise to improve health care. And Raju Kucherlapati, who heads the Center for Genetics and Genomics at Harvard Medical School, says the roughly $2 billion DNA testing industry is poised for growth.

Dr. RAJU KUCHERLAPATI: Within the next ten years or so, it's expected it might go to as much as $15 billion. So in terms of the overall size of the market, it's not huge, but the rate of growth is expected to be very significant.

KAUFMAN: The genetic testing industry is just the tip of the iceberg, some of the earliest applications of what is being called a personalized approach to medicine.

Wendy Kaufman, NPR News, Seattle.

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