Great Lakes Cancer Management Specialists

The cellular iron exporter ferroportin, encoded by the SLC40A1 gene, plays a critical role in systemic iron regulation by mediating uptake of iron from duodenal enterocytes and release of macrophage iron stores into the plasma.Mutations in SLC40A1 underlie a clin. heterogeneous iron overload disorder that exhibits autosomal dominant transmission.Here we characterize a novel SLC40A1 mutation identified in a kindred in which iron overload was treated successfully by phlebotomy.Ferroportin shares homol. with the major facilitator superfamily of transporters and possesses 12 transmembrane helixes arranged in two domains (N and C).Mutations that impair iron export function result in the classical ferroportin disease phenotype characterized by hyperferritinemia, normal transferrin saturation, and macrophage iron loading, and mutations that impair the regulation of ferroportin by hepcidin result in a non-classical form of the disease exhibiting high transferrin saturation and hepatocellular iron loading.

Faced with declining reimbursement for infusional therapies, an oncology practice turned to physician dispensing to offset the loss. Its leaders quickly discovered that the dispensing-vendor landscape was limited, and few guidelines existed for product line development. Yet the approach offers a competitive response to the changing health care landscape. With physician-dispensing prescription costs 50 percent below the national average and generic substitution 50 percent higher than the national average, the potential cost savings for payers and consumers is staggering.