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Exagen Diagnostics Inc. Partners with Medco Research Institute® to Develop NIMBLE Personalized Medicine Program for Rheumatoid Arthritis Patients
Date:5/23/2011

FRANKLIN LAKES, N.J., and ALBUQUERQUE, N.M., May 23, 2011 /PRNewswire/ -- Exagen Diagnostics, Inc., a specialty diagnostics laboratory that discovers, develops and markets proprietary tests, and Medco Research Institute, LLC -- a wholly-owned subsidiary of Medco Health Solutions, Inc. (NYSE: MHS) -- announced today they have started a joint pilot program called NIMBLE [Novel Interventions in Methotrexate Boosts Levels of Effectiveness] designed to help physicians optimize the effectiveness of low-dose methotrexate therapy for patients who suffer from rheumatoid arthritis (RA).

(Logo: http://photos.prnewswire.com/prnh/20100609/MEDCOLOGO)

An estimated 1.3 million adults suffer from RA in the United States, many of whom are treated with low-dose methotrexate (MTX).  MTX is safe, relatively low cost and highly effective; however, it is difficult to determine the optimal dose for individual patients due to the highly variable absorption, excretion and metabolism rates for each patient. Historically, physicians have depended solely on clinical signs and patient symptoms, which do not always indicate how changes to the treatment therapy might benefit the patient. In many cases, if a patient does not respond to MTX therapy within six to eight weeks, they are often prescribed biologic therapies.

The NIMBLE pilot program will use Exagen's proprietary Avise PG lab test to measure whether patients are receiving an appropriate dose of MTX. Avise PG measures MTX polyglutamate levels, the active metabolites of MTX. These measurements can help establish how MTX is being absorbed, retained and metabolized by the patient.  With this information, a physician can more accurately adjust the dose of MTX, making it more effective for the patient.

"Molecular tests, like Avise PG, can help make prescribing more precise by providing information that tells the physician which dose, or even which medication, will work best for an individual patient.  This is especially important when the next-in-line therapy is a biologic medication that can cost a patient and payor significantly more, and may come with additional negative side-effects," said Felix Frueh, Ph.D., president, Medco Research Institute. "The findings we observe through the NIMBLE pilot will be an important step in understanding the value of testing like this, and may bring us closer to making this testing standard practice for RA patients."

Medco Research Institute will work with Medco clients to recruit patients to take part in the NIMBLE pilot program.  When a member of the participating plans receives an initial prescription for MTX for the treatment for RA, Medco will provide the prescribing physician with the Avise PG test, and patients will be alerted that a blood-draw for the Avise PG test will be performed at their next office visit.

Once the physician's office has collected the blood sample, it will be sent to Exagen Diagnostics' CLIA-certified laboratory for testing. Exagen will provide the test results to the prescribing physician to make dose changes accordingly, and to Medco Research Institute.  

It is anticipated that up to 400 Medco members who are new to MTX therapy will have the Avise PG testing performed. The downstream medical and pharmacy claims data from these patients will be compared to a similar number of Medco members who did not received Avise PG testing as part of their care in order to determine the clinical utility and cost effectiveness of this intervention.

"We are very pleased to partner with such a patient-focused organization to provide physicians this opportunity to optimize treatment of a very painful and expensive disease," said Scott Glenn, Exagen CEO.

About Exagen Diagnostics, Inc.

Exagen Diagnostics is the emerging leader in laboratory-discovered and developed diagnostic tests specifically designed to provide objective information to physicians and patients for more accurate, efficient diagnosis and better disease management. Using Coperna®, the company's proprietary, algorithm-driven computational tool and search engine running on high-performance computational clusters, Coperna combines the ability to process massive amounts of data contained in genomic datasets with intelligent, rapid search methods. Coperna's targeted and precise discovery model has no conventional equivalent in the industry as it can identify relevant marker sets with superior sensitivity and specificity relative to markers identified via traditional analytical methods. For more information, please visit www.exagen.com.

About Medco Research Institute

Medco Research Institute® is an evidence-based research organization focused solely on novel research, analytics and new discoveries that close the gap between scientific discovery and medical practice for improved patient outcomes and lower overall healthcare costs. More information about the Medco Research Institute's peer-reviewed research can be found at www.medcoresearch.com.

About Medco Health Solutions, Inc.

Medco Health Solutions, Inc. (NYSE: MHS) is pioneering the world's most advanced pharmacy® and its clinical research and innovations are part of Medco making medicine smarter™ for approximately 65 million members.

With more than 20,000 employees worldwide dedicated to improving patient health and reducing costs for a wide range of public and private sector clients, and 2010 revenues of $66 billion, Medco ranks 34th on the 2011 Fortune 500 list and is named among the world's most innovative, most admired and most trustworthy companies.

For more information, go to http://www.medcohealth.com.

This press release contains "forward-looking statements" as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements involve risks and uncertainties that may cause results to differ materially from those set forth in the statements. No forward-looking statement can be guaranteed, and actual results may differ materially from those projected. We undertake no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise. Forward-looking statements in this press release should be evaluated together with the risks and uncertainties that affect our business, particularly those mentioned in the Risk Factors section of the Company's Annual Report on Form 10-K and Quarterly Reports on Form 10-Q filed with the Securities and Exchange Commission.


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