ATLANTA — Doctors are reporting an exciting win for gene testing and
personalized medicine: Checking patients' DNA before starting them on
a popular blood thinner helps get the tricky dose right and keep them
out of the hospital.

The drug is warfarin, sold as Coumadin and in generic form. About 2
million Americans start on it each year to prevent blood clots after
surgery or for other medical conditions.

However, the world's most common blood thinner is also one of its most
dangerous drugs. One person's ideal dose can be 10 times that of
another's. Even certain foods can throw it off.

Too much warfarin can lead to bleeding, too little can lead to clots,
and either one can kill. Up to 20 percent of patients wind up in the
hospital in their first six months on the drug.

Several companies sell tests for the two genes that control how
warfarin is metabolized. But doctors wonder: Is it worth a
$250-to-$400 test to guide the dose of a drug that costs less than $6
a month?

A new study, presented Tuesday at an American College of Cardiology
conference, suggests it is.

Patients given gene tests to set their initial warfarin dose had about
a 30 percent lower risk of being hospitalized than similar patients
whose doses were set by trial and error.

"If we reduce just two hospitalizations per 100 patients tested, that
more than compensates for the cost," said the study's leader, Dr.
Robert Epstein. He is chief medical officer of Medco Health Solutions
Inc., a New Jersey-based pharmacy benefits manager for many big
insurance companies.

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