Natural Molecular Today Issue 1 // September 2012 EMBRACING PHARMACOGENOMICS LEADERSHIP
ROLE, NMTC LAUNCHES PRIDE® REGISTRY
WRITTEN BY: KEN WALLACE, NMTC Director of Business Development
.revolutionizing Dr. Huey McDaniel ON A DAILY BASIS we see that personalized
medicine is having a dramatic positive impact on the treatment and quality of life patient care through of patients. Even more intriguing is the potential of pharmacogenomics to improve the quality of healthcare on a number of levels. Together with our forward-thinking physician Though a growing amount of scientific data partners and other healthcare professionals, we supports the utility of pharmacogenetics, it is still in intend to play an important role in revolutionizing its infancy. Embracing a leadership role in this field, patient care through personalized medicine. The NMTC is investing considerable resources towards trial-and-error approach in prescribing medications research to bolster scientific understanding of will soon be a thing of the past. The focus will shift pharmacogenetics within the health care community.
to implementation of pharmacogenetic testing to "Personalized Medicine: Our One of our first research initiatives is the PRIDE® avoid adverse drug-related complications. It's better Registry (Practice Innovation and Drug Evaluation). for the patient, it's better for the physician, and it's Designed primarily by our Chief Medical Officer Dr. better for the healthcare industry as a whole. Stay Connected With Us Karthik Kasirajan, who has a number of years of NMTC is committed to broadening the clinical experience in clinical research as a vascular surgeon, understanding of pharmacogenetics through our PRIDE® is a cardiovascular disease registry launched research, and sharing that knowledge with the global on a pilot-basis in May, 2012. Working with selected partner clinics, we are Rob Clemens, Sales Rep collecting and statistically analyzing a vast amount of patient data and its relationship with CYP450 genetics. The data collected to date has shown great promise For More Information on the "A Remarkable Turnaround" and we will continue to share findings with our partner clinics, clients, other partners and members of the scientific community. Through the PRIDE® Registry and other efforts, Please contact us at 1-888-442-8881 or
we look forward to making a significant contribution to the scientific understanding of pharmacogenetics and its clinical benefits.
CONSULTING PHYSICIAN: CARDIOVASCULAR
WRITTEN BY: HUEY MCDANIEL, M.D., St. Dominic CV Surgery Associates, Jackson, MS
GENETIC TESTING plays an integral be due to noncompliance, environmental have shown that this reaction is linked to a
role in delivering personalized care— factors or complex interaction between diet/ specific set of genes. Thus, since around with optimized outcomes—for my drug. Many reasons, however, can easily be 2008, doctors have been advised to screen discovered before a drug is ever prescribed. patients before prescribing Abacavir. As clinicians we recognize there are genetic I cannot imagine starting a new drug Similarly, genetic testing information is differences to the prevalence of disease therapy before having a clear understanding already in use for determining how the blood processes in our patients. Some people simply of the patient's genetics. thinner Coumadin (Warfarin) should do not have the genetic machinery needed to make a drug active, or deactivate an already Genetic testing to play larger role in
The next time you open the Physicians active drug.
Desk Reference or pull up Epocrates on your Why would anyone want to look past genetic smartphone, look under "pharmacology" differences in how patients respond to In the recent past, clinical trials deliberately for the drug you are about to prescribe. ignored a patient's background and genetics Nine-out-of-ten times you will see which Using genetic testing over the past eight to avoid bias. If a drug worked well for most cytochrome P450 family is used for the months, I've learned that nearly one third of my people, doctors would prescribe it to nearly metabolism of that drug. patients undergoing screening lack the genetic everyone with that condition. This, however, We should not assume the patient is machinery to effectively metabolize the anti- didn't tell us how a particular patient would having any benefit just because they are not platelet agent Clopidigrel (Plavix) into its active respond to a drug. having an adverse drug reaction. You will be form. A large number of patients either need The risk of side-effects is something we surprised at how many patients do not have another anti-platelet agent or a much higher once accepted every time we swallowed a pill. the genetic makeup to allow your prescribed dose. Armed with this valuable information, But it's one we'll no longer have to accept I am now able to as new medical trials " It is estimated that adverse optimize outcomes now include patients' You won't know unless you test. drug reactions ranks between genetic background. If we all had our genomes 1. Trends in Molecular Medicine, Volume 7, Issue 5, fourth and sixth biggest 201-204, 1 May 2001 doing a vascular analyzed, we could 2. Incidence of Adverse Drug Reactions in Hospitalized killers in the United States. " steer clear of the drugs Patients: A Meta-Analysis of Prospective Studies, JAMA that are ineffective or even dangerous. This 1998;279(15): 1200-1205 Drug intolerance widespread
kind of personalized medicine could save 3. Building On Our Inheritance: Genomic Technology in Healthcare. A report by the Human Genomics Strategy millions in unnecessary medical costs.
Group. January 2012.
Intolerance to medications is widespread. With Scientists are beginning to back the idea some tumor drugs, 70% of the population won't with greater force. A recent report by the respond. Patient intolerance levels include Human Genomics Strategy Group, which asthma medications (40%), antidepressants advises the UK government, laid out a vision (38%), diabetes medications (43%), arthritis for the National Health Service in 2020 that drugs (50%) and Alzheimer's drugs, as many as included genetic testing. They advocate using 70% (reference 1). patients' genetic profiles to avoid drugs that Unfortunately, intolerance to a drug is could harm them. The group's chair, Sir John something patients and physicians discover Bell, a former president of the Academy of only after it's been prescribed. It is estimated Medical Sciences, said that a national DNA that adverse drug reactions rank between the database might be needed in the fourth and sixth biggest killers in the United future (reference 3).
States. Adverse drug reactions remain a big A precedent has already been set in using killer in Europe, as well as in the US genetic screening prior to administering (reference 2).
Abacavir, an HIV drug. 1–2% of people develop The reasons that people don't respond to a severe, allergic-type reaction to it, and drugs are certainly more than genetic. It can for them, it can be life threatening. Studies
FROM THE CEO
WORKING WITH A RAPIDLY growing number of partner
physicians and clinics, NMTC continues to expand, and we Sales Representaive are moving our corporate offices into a larger location this month. It's a very exciting chapter in our company's growth! ROB CLEMENS is championing for Natural
At NMTC we strive for perfection and we recently passed the
Molecular Testing Corporation, talking to many doctors about our services, which can be CLIA inspection with zero deficiencies. Our goal remains
applied to better treating patients. constant: to maximize our clients' satisfaction and the outcomes of their patients.
TELL US ABOUT YOURSELF.
I am very proud of the entire NMTC team—our office staff,
I was born in Texas about one hundred years ago. I was an army brat and grew up in Michigan. I've been in medical sales for twenty-seven lab technicians and representatives in the field—for their years and most recently before NMTC, I was in the pacemaker and outstanding contributions, hard work and dedication to the company.
WHAT IS YOUR CURRENT POSITION AT NMTC? HOW LONG HAVE YOU BEEN IN THIS POSITION? Well, on my card it says, "Genetic Testing Specialist," but I consider myself a "swabber." I did my first swab December 19, 2011.
WHICH STATES DO YOU CURRENTLY SERVE FOR NMTC? For the most part, doctors are becoming more conscious of this I spend 95% of my time in Michigan and we also have the rights to growing field. Currently, from when I originally started in December, the city of Las Vegas. We're just opening up a few practices in Los genetic testing has become widely recognized by the medical Angeles, too.
community. Not just by the efforts of me or people like me, there are more and more articles in journals and newspapers. At local and WHAT DO YOU ENJOY MOST ABOUT WORKING FOR AND national meetings and conventions, genetic testing is written about REPRESENTING NATURAL MOLECULAR? and discussed. Literally 6 or 7 months ago, it wasn't being talked It's fun to finally know more about something than the doctors do. about and now most doctors are cognizant of it.
In most instances, we are educating them; NMTC is ahead of the curve. It's fun to be on the cutting edge like that, and to be used as a HOW WOULD YOU PICTURE PERSONALIZED MEDICINE IN THE FUTURE? WHAT KIND OF IMPACT DO YOU THINK IT'LL MAKE IN THE NEXT FIVE YEARS? WHAT IS ONE THING YOU WISH ALL DOCTORS KNEW ABOUT It absolutely is the future of medicine. I think that within 5 years, it'll PERSONALIZED MEDICINE? be mandated by law that if a doctor is going to prescribe medication, That the NEED to be involved in pharmacogenomics would be they will have to perform genetic testing, to make sure they're doing beneficial to their patients and practice.
the right thing for that patient. Maybe in 10 years, as in infant, genetic testing will be performed. So from birth, your medications I want to share a funny store with you. When talking to a doctor will be managed based on your genetics, which could save and about why he should be involved in this for his patients, the doctor improve the lives of countless people.
responded, "I don't think this is right for my practice at this time." This doctor was about 50-60lbs heavier than me, so I said to him, "Why don't we go shopping for a new suit? We can each purchase the same size suit, does that sound good to you? And he said, "Why would we do that?" I told him, "No, we want our suits tailored to us, GET IN TOUCH
right?" He responded, "Absolutely." I replied, "That's what we can do WITH A REPRESENTATIVE NEAR YOU! with medicine now. We can tailor medications right to the patient's body." Our reps are a resource of information for you. We have This analogy has worked really well for me, helping doctors representatives all over the country that would be happy to understand what we do, and it makes sense to patients too. contact you and answer any questions you may have. Discuss with your rep how Natural Molecular can help your clinic use HOW HAVE DOCTORS RESPONDED TO USING NMTC'S SERVICE? molecular diagnostics and pharmacogenomics to advance Overall doctors are very satisfied with NMTC's service, they love your patient care.
the improvements we have made in getting results back to them. Previously the results were complicated to decipher and too bulky. Please go to our website at ontact Now we have made the necessary adjustments to accommodate their us at 1-888-442-8881.
practice. We must continue to improve as a corporation to stay ahead of our competition.
PATIENT CASE STUDY
A REMARKABLE TURNAROUND
WRITTEN BY: ANNALISE WONG, NMTC Marketing Assistant
NATURAL MOLECULAR TESTING CORP. is pioneering the clinical utility of
pharmacogenetics, and Stephanie Smith and her family know first-hand its transformative effects.
In 2001, Smith's father underwent quadruple bypass surgery. Shortly thereafter they received a devastating diagnosis: he was suffering from major depression and Alzheimer's disease. Despite being prescribed medication by doctors in Durango, Colorado to help control his depression, it continued spiraling downward. Isolation from friends and family, insomnia, lack of interest in hobbies, and overall cynicism worsened. Prospects for his recovery looked bleak.
Stephanie, a research manager at a Colorado I thought you might cardiology practice participating in genetic testing, appreciate knowing a story suspected this was not an isolated situation. With with a happy ending "
Natural Molecular's services, Mr. Smith was tested for a full CYP 450 panel to determine whether he was on the correct medication. The results: Mr. Smith was a poor metabolizer of the initial medication. Mr. Smith was switched to a different prescription by his physicians, and within a month a drastic change occurred. He began immersing himself once again with the people and activities he loved and the shadow of pessimism dissipated. The agonizing nights of restlessness tapered off.
Rather than just switching him to another drug in the same metabolic pathway, genetic testing eliminated the tedious and frustrating process of trial and error. Stephanie and her father discovered, like many others, that the world of medicine is not a "one size fit all" model. Using genetic testing data, medications and dosages can be specifically tailored for each and every person. Grateful for how genetic testing helped her father, Stephanie writes, "I thought you might appreciate knowing a story with a happy-ending. It's good to be involved with something that truly makes a difference in people's lives." At Natural Molecular Testing, we hope to ensure as many happy patient outcomes as possible.
LAB STAFF HIGHLIGHT
OFFICE STAFF HIGHLIGHT
TELL US ABOUT YOUR TELL US ABOUT YOUR PHYSICIAN
I grew up in Taiwan with I am full Filipino and my my mom, dad, and two family is from Hawaii. brothers. After graduating I've lived in Washington from college in Taiwan I for 20 years. I went to Have your patient's completed my Ph.D at the school to become a University of Michigan. medical assistant and test results at your From Michigan I moved was in the fertility world to Chicago to get my for six years. And now Post Doctorate in Human I'm here at NMTC and Genetics, then Boston absolutely love what I do! and finally Seattle in 2000. My parents lived in Track the status of Vancouver and I wanted to be closer to them.
WHAT ROLE DO YOU PLAY ON THE NMTC TEAM? your patient's sample Client sales and customer service. I set up new HOW DID YOU BECOME INVOLVED WITH NMTC? clients, help our reps and doctors receive test View patient results I met Beau, our CEO, through my old boss while results, and contact offices. working with DNA Genomic Extraction kits.
as soon as they are WHAT DO YOU LOVE ABOUT WORKING AT NMTC? WHAT IS YOUR ROLE AT NMTC? I love the people; it's like working with your family. I make sure everything runs smoothly and test There's always room to help each other and the new technology before we use it in the lab. I love amount of opportunities are limitless. I appreciate print results at your the fast pace of the lab and knowing that I am how there is an open environment where your contributing towards healthcare measurement. opinions really matter. But what I appreciate most is what NMTC represents. We represent a company WHAT DO YOU LIKE TO DO IN YOUR FREE that not only strives to help people, but that upholds Enter your orders the idea of prevention. We are always two steps I like to read, bake, and take dance classes. I go ahead of the curve. I love that! to folkdance classes every weekend. I don't have a favorite recipe I just like making fancy things. FAVORITE PAST TIMES? I will find a recipe online than experiment with Eating! Trying new cuisines, swimming, making new friends, hiking, and traveling.
WHAT IS YOUR FAVORITE FOOD OR WHAT DO YOU LOVE ABOUT LIVING IN SEATTLE? I love only having a five minute commute to work. I love all food…just as long as it tastes delicious! The mountains and scenery are great as well.
We improved our request WHAT IS YOUR FAVORITE BOOK? BEST RESTAURANT IN SEATTLE? forms. Please make sure to Jane Austen's Pride and Prejudice. I like the That's easy! Any place with lots of meat. The story and the main character. I think the book is Metropolitan Grill in Seattle is amazing.
fill out all required fields and better than the movie.
choose the correct WHO INSPIRES YOU? ICD-9 codes.
WHAT MADE YOU CHOOSE TO WORK IN A LAB? Oprah. She is a strong woman who is always finding Madame Curie, the founder of radio activity, ways to help others. Also, Donald Trump. He is as and Darwin, because he had a great effect on straight forward as it comes and I think honesty is an admirable trait.
DNA Test Request Form
WHAT IS YOUR DREAM VACATION? WHAT'S YOUR PERFECT SATURDAY? Test results are made available online
TYPE OF SAMPLE SUBMITTED
Please check at least one box below: A quiet beach as long as it's not too warm and I Hiking and then going to the beach to take a long (CYP2D6, CYP2C9, CYP2C19, CYP3A4, CYP3A5, Thrombo Risk) (CYP2D6, CYP2C9, CYP2C19, CYP3A4, CYP3A5) have access to my own masseuse! nap. And to top it off, a BBQ on the beach with lots PATIENT / COLLECTION INFO
of meat to share with my friends and family! WHAT IS YOUR FAVORITE QUOTE? PATIENT INSURANCE INFO
"Don't worry, be happy"… I think it's from the Check a payment box & complete information:
"The Five People you Meet in Heaven" by Mitch Albom and "The Gift" by Lewis Hyde.
PHYSICIAN AUTHORIZATION / ICD-9
DO YOU HAVE ANY EXCITING PLANS FOR Physician ICD-9 Code (required)
DREAM VACATION SPOT? I'm going to China for two weeks with my Patient Consent (optional)
mother. We joined a travel group and most of my relatives are traveling with us. I'm excited! TOP THREE FAVORITE MOVIES?The Dark Night Rises, Happy Feet, and The Lorax.
IN THE OFFICE
FROM THE STAFF
"I like that we are a they enjoy most about progressive and innovative working for NMTC, our
facet of health care. That staff had many good our company fosters learning and growth. I am surrounded by intelligent "What I like best about individuals who value working at NMTC is being a part of such a passionate, - ROSEANNE
ambitious team that is focused on improving "I like the cutting edge patient care one patient at technology . Fast pace. a time." - KEN
We help doctors manage patient care." - ABIGAIL
"The awesome and friendly people I work with." "Our great team of people and I'm learning new things every day. It's "I like the environment. exciting!" - SARA
Jancy Buffington, We know how important Abigail Ting, Betty our jobs are and the "The flexibility, caring staff, significance they have on what we do here. What the peoples' lives. We do our company does and how we best at it." - DONIKA
make a difference in the world. We have the staff "What I love most about with great work ethics." NMTC is our staff as - FELICIA
well as our vendors and independent sales reps we "Cutting edge technology, educating physicians and - BREONNA
patients, the company environment, the "I honestly think what opportunity for growth, and NMTC is doing is opportunity to learn more important. Personalized about genetics." medicine is the future." - JOHNATHAN
"It is great to work for a "I really enjoy the people company that is focused I work with and what I do on making the lives of truly makes an impact in others better. NMTC is full of smart, dedicated and - ANNALISE
friendly employees that create a great working "The new technology and environment and make pushing things forward." coming to work very enjoyable." - BETTY
"I like the team "The flexibility of environment." - KATIE
scheduling along with others willingness to fill in "I love the collaborative as needed. Also, the size environment and putting of the company is small new technologies to enough to still celebrate positive use." - IAN
birthdays and other events." - BRIAN
"How nice the people I work with are and the "I love that we're pushing camaraderie. The sense of the boundaries in the mission and the sense of medical industry." purpose." - RICK
"The kind atmosphere." - BRANDON
SERVICE TO YOU
WRITTEN BY: BYRON KWOK, NMTC IT Support
ADVANCING both doctor and
patient education is paramount to the success of personalized medicine. Available to both our partners and the public, the Learning Lounge on our website (naturalmolecular.com) is a go-to source for information. It offers a growing number of "news you can use" educational OUR IT TEAM. From left: Ian Crofoot, Justin Greywolf, and Byron Kwok.
materials, published papers, video tutorials and other information on the emerging role patient testing information, our website's so please never hesitate to give us a call Physician Portal securely allows doctors at 1-888-442-8881 or send us an email
We also spotlight blog posts from Dr. to order tests and view test results online. Karthik Kasirajan, Natural Molecular Physician Portal utilizes our database to give Testing Corporation's Chief Medical Officer doctors advanced reporting functionality and and noted cardiovascular surgeon, and convenient access to patient reports. other contributing luminaries. In addition to Physician Portal, our IT Are you planning to attend an upcoming Department is currently working with multiple conference or tradeshow? Our website clinics to build an EMR interface capable of Learn more about our services, how to features a Tradeshow map of upcoming receiving test orders and delivering results order kits, and get answers to our most tradeshows and conferences NMTC will be frequently asked questions.
directly to physicians. participating in, along with links to each We'll soon be able to deliver results straight event's website for additional information.
to your EMR system, making your testing experience as smooth and effortless Physician Portal—a personalized
approach to delivering patient information
Please feel free to refer your colleagues and patients to our website for more information Different patients require different about NMTC's service—and the science approaches with medicine, and we share that philosophy in delivering online tools Our IT Department is happy to troubleshoot and IT services tailored to a physician's any issues you may have while using our tools, needs. Providing immediate access to SOCIAL MEDIA
Connect with us on twitter "Like" us on Facebook Our Learning Lounge and receive the latest and stay up to date on is a great resource for updates about our company articles published by Dr. educational materials as and interesting articles Karthik Kasirajan, our Chief well as NMTC updates.
from the medical field.
and learn more about genetic testing.
FROM THE DESK OF
THE EXECUTIVE VICE
HQ NMTC HEADQUARTERS
223 SW 41st St.
PRESIDENT AND THE
NATIONAL SALES DIRECTOR
Convention season is in full swing and Natural Molecular will be playing a big role in a variety of regional and national conventions. Here is a sample of some of the conventions SEPT. 22-25
where you will find the Natural SEPT. 5-8
Pain Week, Las Vegas, NV (Sept. 5-8)
Western Vascular Society, Park OCT. 13-19
City, UT (Sept. 22-25)
[Miami Maui Cardiology, Maui, HI VIVA, Las Vegas, NV (Oct. 9-12)
NCPA, San Diego, CA (Oct. 13-15)
Please visit the Tradeshow section of our website for updates, our booth locations and presentations at these and other upcoming events. We'll be participating in a growing number of these important conferences and we look forward to By: Mark Haley and Kenny Webert
Une nouvelle génération de femmes d'affaires conquiert le monde et l'Afrique. Elles sont diplômées, à la tête d'entreprises, elles gèrent des projets ambitieux, des budgets importants, des ressources humaines. Elles sont l'élite de la finance et de l'économie dans leur pays. Elles construisent une nouvelle image de la femme Working Girl et Business Woman.
15-daagse rondreis israël
15-tägige Rundreise nach Jordanien 19. Mai - 2. Juni 2014 3 Meere – 3 Wüsten – 3 Städte. Höhepunkte: 7 Offenbarungsberge Gottes – Tiefstpunkt der Erde: Das Tote Meer Israel, das Land in dem Gott Geschichte gemacht hat. Wir besuchen berühmte Städte wie Tel