Dental unit waterline contamination: a review of research and findings from a clinic setting.

The interior of small-diameter tubing in dental unit waterlines (DUWLs) creates an attractive environment for the growth of biofilm and bacteria. Substantial research shows that troublesome and potentially pathogenic bacteria have been found in DUWLs, and scant peer-reviewed information from which to evaluate chemical treatment options has been historically available. The authors' research compares three DUWL cleaners-an alkaline peroxide product, a freshly mixed chlorine dioxide product, and a buffer-stabilized chlorine dioxide product-in 16 dental units with self-contained water systems over a 10-day working period to determine the optimal chemical treatment option.

Regulatory and reimbursement innovation.

Coverage with evidence development and parallel review for molecular diagnostics aid regulation and reimbursement.

The economics of personalized medicine: commercialization as a driver of return on investment.

Optimizing commercialization of drugs is the sine qua non of the pharmaceutical industry and intensive work has been done to characterize fully the drivers of drug adoption and understand the resources required to optimize those drivers for full adoption of drugs. Conversely, while the pharmaceutical industry is actively embracing the new personalized medicine (PM) paradigm, much work remains to be done to understand fully what drives adoption of targeted therapies and how to resource those drivers appropriately. While the industry is slowly learning from its early missteps, progress is still inhibited by a lack of understanding of the specific hurdles that individual development teams face in developing and commercializing targeted therapies and the requirement for budgets specifically aimed at driving test adoption.

Driving personalized medicine: capturing maximum net present value and optimal return on investment.

In order for personalized medicine to meet its potential future promise, a closer focus on the work being carried out today and the foundation it will provide for that future is imperative. While big picture perspectives of this still nascent shift in the drug-development process are important, it is more important that today's work on the first wave of targeted therapies is used to build specific benchmarking and financial models against which further such therapies may be more effectively developed. Today's drug-development teams need a robust tool to identify the exact drivers that will ensure the successful launch and rapid adoption of targeted therapies, and financial metrics to determine the appropriate resource levels to power those drivers.

Personalized medicine: using effective partnering for managing the risk of legal liability.

Beyond the economic cost-benefit analysis of incorporating pharmacogenomics into the process of drug development, it is time for the players in the industry to begin considering the long-term potential legal liabilities that may arise, and to undertake a legal analysis to identify and avoid those risks to the greatest possible extent. The current economic model being considered for pharmacogenomics technologies fails to take this legal risk into consideration, and therefore does not provide a complete picture of the incentives and disincentives of entering into this space. However, the more evenly weighted balance of all of the economic interests - costs, benefits and risks - can be tipped into the positive through effective partnering relationships between the pharmaceutical and diagnostic industries, and the diagnostic industry and pharmacy benefit managers.