Research to Evaluate the Cost Effectiveness of Interventions with Prescriptions of Thiopurines (RECEIPT)

The Medco Research Institute^® and Prometheus Laboratories Inc., a specialty pharmaceutical and diagnostics company that is part of Nestle Health Science, have entered into a collaboration to evaluate the use of Prometheus' Thiopurine Metabolite (PTM) testing for optimizing dosing of 6 mercaptopurine (6MP) or azathioprine (Aza) in patients with inflammatory bowel disease (IBD). Optimization of dosing could lead to improved drug response and delay progression to more aggressive therapy.

Thiopurine immunomodulators, such as 6MP or its pro-drug Aza, are effective medical treatments for IBD when appropriately dosed. However, studies have shown that patients are frequently under dosed which can decrease the efficacy of these drugs. Through PTM testing, doctors may be able to select those patients who would benefit from dose adjustments and those that may have a risk of toxicity. Patients who are not responding due to lack of compliance could also be identified. This collaboration will evaluate whether PTM testing, used early after the decision is made to prescribe thiopurines, increases the time that patients remain on these drugs and thus reduces the rate at which patients transition to expensive alternative treatments.

Through this collaboration, the companies will conduct the RECEIPT project (Research to Evaluate the Cost Effectiveness of Interventions with Prescriptions of Thiopurines), a pilot program to evaluate the benefit of PTM testing in IBD patients who have recently received a prescription for either 6MP or Aza. In addition, the collaboration will evaluate the cost effectiveness of PTM testing.

The Medco Research Institute will work with Medco clients to recruit patients to take part in the pilot program. It is anticipated that up to 500 Medco members who are using 6MP or Aza will have the PTM testing performed, and the downstream medical and pharmacy data from these patients will be compared to a similar number of Medco members who did not received PTM testing as part of their care, in order to determine the impact of PTM testing.

Personalized medicine is an area of healthcare that is becoming more widely used to focus on how a person's molecular makeup can affect their ability to respond to medications, allowing physicians better precision in selection or dosing of a drug thereby improving drug safety and efficacy.