title: On rat poison and human medicines: personalizing warfarin therapy.
abstract: Teaching old dogs new tricks is difficult, but lessons learned from such efforts can be invaluable. Warfarin is an old drug, difficult to administer and a leading cause of drug-related mortality and hospitalizations. New genetic tests for optimizing warfarin therapy have not been adopted. The debate over precise clinical utility and cost-effectiveness of these tests misses more important points of building a better, cheaper, and more efficient infrastructure to measure the true real-world impact of personalized medicine. However, this same debate about how, when, and where such testing is appropriate has been invaluable to the field of personalized medicine: progress beyond science, in policy, regulations, and logistics can be highlighted along the path to safer and more efficacious warfarin therapy.
authors.affiliation: Medco Research Institute, LLC, 7315 Wisconsin Avenue, Bethesda, MD 20814, USA. Felix_Frueh@medco.com
authors.forename: Felix W
authors.initials: FW
authors.lastname: Frueh
mesh_terms: D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use; D005820:Genetic Testing; D006801:Humans; D010597:Pharmacogenetics; D057285:Precision Medicine / Q000379:methods*; D051381:Rats; D012378:Rodenticides; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D012378:Rodenticides; D014859:Warfarin