New diagnostic tool aids in pathogen identification; kiosks in doctors' offices provide generic drug samples

Researchers at the Infectious Disease Laboratory at Columbia University Mailman School of Public Health and the World Health Organization (WHO) Global Laboratory Network have developed a new diagnostic tool called the "GreeneChip," a glass slide that can rapidly and accurately identify multiple pathogens from different biologic samples (eg, tissue, blood, urine).

Numerous DNA or RNA samples (probes) of bacteria, viruses, fungi, and parasites are embedded on the slide; when the biologic sample is applied, the probes adhere to closely related genetic material in the samples, helping researchers identify the pathogen. The GreeneChip was tested on samples from patients with respiratory disease, tuberculosis, hemorrhagic fever, and urinary tract infections, yielding pathogen diagnoses that were as accurate as those obtained using traditional methods such as culturing or utilizing polymerase chain reaction (PCR) to identify the pathogen's genetic makeup.

The GreeneChip may assist prescribers in identifying an infectious agent as either a virus or a bacterium and may help decrease misprescribing and overprescribing of antibiotics. Use of the GreeneChip also might reduce the need for a more invasive diagnostic workup (eg, sinus puncture, aspiration, spinal tap).

According to the National Institute of Allergy and Infectious Diseases, this new technology may improve the capability for emerging infectious disease surveillance and outbreak response. The GreeneChip requires additional work to perfect its use and is not yet being used commercially.

KIOSKS DISPENSE GENERIC SAMPLES IN PHYSICIAN OFFICES

MedVantx is marketing an automated drug-delivery system that provides free first-line generic medication samples to patients at the point-of-care in the physician's office.

Unlike large pharmaceutical companies, generic drugmakers do not have large numbers of sales representatives to stock physician office sample closets. The kiosks are stocked with some of the most commonly prescribed generic drugs (eg, amoxicillin, fluoxetine, furosemide, glipizide, lisinopril, lovastatin, metformin, metoprolol).

The MedVantx Sample Center dispensing kiosks have been available since 2003 and are being used by approximately 2,500 physicians in approximately 350 offices nationwide. The system is recommended by insurers in 8 states to help offset healthcare spending by promoting increased use of generic drugs. Insurers pay for kiosk placement and MedVantx provides the drug samples; a 30-day supply is typically dispensed for physicians to initiate therapy. In addition to dispensing medications, the kiosk also generates patient education materials, printed chart notes, and refill labels. The kiosk automatically records and reports inventory, health plan eligibility, regulatory compliance, and utilization tracking data; the system fulfills Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Drug Enforcement Administration (DEA), and Prescription Drug Marketing Act sample documentation requirements.

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"GreeneChip": New tool with broad use. Pharmasentry website. Available at: http:// http://www.pharmasentry.com/news/newsletter.cfm?linkid=7f304b50%2d1372%2d54c2%2d617e2c56018552df. Accessed January 16, 2007.

Palacios G, Quan P-L, Jabado OJ, et al. Panmicrobial oligonucleotide array for diagnosis of infectious diseases. Emerg Infect Dis [serial online]. 2007;13:73-81. Available at: http:// http://www.cdc.gov/ncidod/eid/13/1/pdfs/73.pdf. Accessed January 16, 2007.

Marburg hemorrhagic fever. Known cases and outbreaks of Marburg hemorrhagic fever, in chronological order. CDC website. Available at: http:// http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg/marburgtable.htm. Accessed January 16, 2007.

MedVantx website. Available at: http:// http://www.medvantx.com/. Accessed January 16, 2007.

Silverman E. Doctor's office kiosks dispense generic drug samples. Newhouse News Service website. Available at: http:// http://www.newhousenews.com/archive/silverman121506.html. Accessed January 16, 2007.