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Patients Who Know Their Gene Test Results are More Likely to Regularly Take and Remain on Statins, Study at ACC Shows
Date:3/26/2012

CHICAGO, March 26, 2012 /PRNewswire/ -- Genetic tests can help physicians more accurately diagnose and treat disease, but now there is evidence that these tests can also influence behavior -- motivating patients who are told of their test results to regularly take and stay on medications to treat high cholesterol.  The results of the Additional KIF6 Risk Offers Better Adherence to Statins (AKROBATS) study was presented today by investigators from the Medco Research Institute™, a subsidiary of Medco Health Solutions, Inc. (NYSE: MHS) and Quest Diagnostics (NYSE: DGX), the world's leading diagnostic testing company, at the American College of Cardiology's 61st Annual Scientific Session & Expo. 

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

The study found that patients who were provided written information about their kinesin-like protein 6 (KIF6) gene test improved their overall adherence to statin therapy over six months, the study's primary end point, by 13 percent compared to those that had not received the gene test.

"Medication adherence is an extremely important global issue in patient care, and in particular for evidence-based therapies that help to lower cholesterol and reduce the risk and cost burden of cardiovascular disease, including heart attack and stroke," said Dr. Scott Charland, senior director from the Medco Research Institute (MRI) and study principal investigator.  "This is the first prospective study to show that genetic testing, and subsequently providing patients their test results, has clinical utility through improving adherence to a specific drug therapy -- a finding that could open-up a whole new way of thinking about the benefits of pharmacogenetic testing."

Study Details
The study examined medication adherence of 1,294 patients that were newly prescribed statins.  A laboratory-developed gene test to measure KIF6 carrier status was provided to 647 patients while 647 patients in the control group did not receive a genetic test.  The two groups were matched for age, gender, prescription distribution channel, and the number of chronic medications used.  After controlling for other patient characteristics known to affect adherence (such as co-morbidities and socioeconomic status), tested patients who were informed of their test result had significantly higher overall adherence to their statin treatment as measured by the proportion of days with medication on hand over a six-month period, the study's primary end point (77 percent of days covered versus 68 percent). 
Furthermore, tested patients were almost two times more likely (99 percent) to be categorized as adherent as measured by patients who had statin medication on hand 80 percent or more of the time. They were also 83 percent more likely to be persistent, meaning they stayed on their statin therapy for the full six months.  AKROBATS is registered on www.clinicaltrials.gov (NCT01068834).

"We focused on statins in this study because of the tens of millions of patients prescribed these medications in the US every year, the drug spend, the known low degree of adherence and persistence to them, and the modest impact of most adherence interventions to date," said Dr. Eric Stanek, MRI vice president, and senior author on the study.  "Given the well-established relationship between increasing statin adherence and reduced cardiovascular events and overall costs, as well as improved workplace productivity, it's exciting to begin thinking about genetic testing or other personalized medicine approaches as useful new tools to empower and motivate patients to increase adherence and persistence."

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 Quest Diagnostics and Berkeley HeartLab
Quest Diagnostics, the world's leading diagnostic testing company, offers genetic and non-genetic testing through Berkeley HeartLab, the company's business unit specializing in advanced cardiovascular disease testing. Berkeley HeartLab offers the 4myheart program, an educational program for patients that provides personalized care, including for medication adherence, to help patients improve their cardiac health. Quest Diagnostics offers a laboratory-developed test for the KIF6 gene variant through Berkeley HeartLab. For more information, visit www.QuestDiagnostics.com or www.4myheart.com.

About Medco
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 millions of Americans.

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 2011 revenues of $70 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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