MEDx Prime’s Chief Medical OfficerDr. Peter F. Demitry

Former Assistant Surgeon GeneralU.S. Air Force

• Fastest turn-around time - 3-5 business days• Developed the solution for processing PGX• Developed over 500 tests, incl early cancer

screening that detects some types of cancerup to 6 months earlier than any other test

• Far superior toxicology results (tests for 56 drugs)• Move urine specimens with blood immediately to

early cancer screen, so can be detected earlier• Revenue sharing program for qualified facilities• Easy to read reports• Advisors available for consultation daily• FREE SUPPLIES & SHIPPING• WALLET CARD for quick reference for any dr

Our Laborat

ory

Pharmacogenetics is the study of genetic variations that influence individual response to drugs. “It is the science that allows us to predict a response to drugs, on an individual’s complete genetic makeup.” −Felix Frueh, Associate Director of Genomics, FDA

Pharmacogenetics = Personalized Medicine

Helps prescribers individualize drug therapy, decrease the chance for adverse drug events, and increase the effectiveness of drugs.

Availability of testing in your medical practice with ease

•Non-invasive buccal swab. •Covered by most insurance companies

•OB: refer to Black Box Warning of Codeine and other analgesics

•PharmD reports are included with tests: equivalent to private, individual Consult for each patient discussing drug – gene, drug –drug interactions with

recommendations for alternatives.

•Financial Exposure to Patient: One-time, lifetime test for patient vs other routine tests such as CBCs that over a

lifetime equal much more overall cost. Potential Rx savings on unnecessary drugs when precise dosing is achieved first

time around.•Weigh risk – benefit – one-time cost; peace of mind for

patient and physician; better patient satisfaction and compliance, better outcome; less liability to physician.

Eliminate trial and error: “Right Drug, Right Dose, Right Indication, Right Patient, Right Time”

Why Should Physicians Test their Patients?

Eliminate “One Size Fits All”medication managementEnhance Patient Care

Enhance Patient Satisfaction

Enhance ComplianceRisk Management: Reduce liability to physician

FDA has posted 130 Black Box Warnings

Manufacturers recommend pharmacogenetic testing prior to or soon after initiation of therapy. FDA has also posted 16 drugs where it requires pharmacogenetic testing prior to prescribing.

http://www.fda.gov/drugs/scienceresearch/researchareas/pharmacogenetics/ucm083378.htm

Cleveland Clinic Journal of Medicine, Volume 78, Number 4, April 2011

Pharmacogenomic testing: Relevance in medical practice Why drugs work in some patients but not in others

• Inhibitor– A substrate(drug) that slows down or “inhibits”

the metabolism of other substrates

• Inducer– A substrate that increase the elimination of

other substrates

•Pro-drug– A substrate that is biologically inactive in its

original (parent) form. These drugs must be metabolized (“activated”)before they are work in the body and produce their desired effect

Definition of Terms Used Regarding Drug Properties

Drug Metabolizing Phenotype

•Ultra Rapid Metabolizers (UM)•Increased enzyme

•Extensive Metabolizers (EM)•Normal

•Intermediate Metabolizers (IM)•Impaired

•Poor Metabolizers (PM)•Non functional

Additional revenue stream that you may not currently be reimbursed for

• SScenario #1- If a Physician group of 5 doctors performs 500 Paps/month with

• 75 biopsies & 20 IHC @ $41 per biopsy and $60/IHC = $ 3,675

• 70 High Risk Pap Profile @ $200/case = 14,000

• 55 TERC FISH @ $140/case = 7,700

• 200 Urine Cytology @ $31/case = 6,218

• 200 Urine Feulgen Stain @ $14/case = 2,800

• 120 UroVysion FISH @ $56/case = 6,720

» Total Monthly PC Revenue$41,113

» Total Annual PC Revenue$493,356

» *Physician group must pay a local pathologist out of the PC revenue

DNA Testing Custom Compounds

Partnership Examples• Scenario #2- If a Physician group of 10 doctors performs 1,000 Paps/month

with

• 150 biopsies & 40 IHC @ $41 per biopsy and $60/IHC = $ 7,350

• 140 High Risk Pap Profile @ $200/case = 28,000

• 110 TERC FISH @ $140/case = 15,400

• 400 Urine Cytology @ $31/case = 12,436

• 400 Urine Feulgen Stain @ $14/case = 5,600

• 240 UroVysion FISH @ $56/case = 13,440

Total Monthly PC Revenue $82,226

Total Annual PC Revenue $986,712

*Physician group must pay a local pathologist out of the PC revenue