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).
Most recently, the GreeneChip was used to identify Plasmodium falciparum as the causative agent in an unexplained fatal case of a patient with a hemorrhagic fever-like syndrome that occurred during
the Marburg hemorrhagic fever outbreak in Angola, Africa, from October 2004 to July 2005. The outbreak resulted in 252 cases
of hemorrhagic fever; 227 (90%) cases were fatal. Most of the cases were confirmed through PCR as being caused by the Marburg
virus, but some were not. Had the GreeneChip been available to confirm the pathogen at onset, the patient could have received
treatment for malaria. 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.
SOURCES New "GreeneChip" identifies multiple pathogens rapidly and accurately. National Institutes of Health website. Available at:
http:// http://www3.niaid.nih.gov/news/newsreleases/2006/greenechip.htm. Accessed January 16, 2007.
"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.
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