Dr. Leon Reyfman, CEO of Advanced Clinical Laboratory Solutions, Inc

We understand that Advanced Clinical Laboratory Solutions, Inc. (ACLS) is a rapidly growing laboratory testing company offering toxicology and pharmacogenetics testing services. What are the major business philosophies or strategies of ACLS?

I began my career as a pharmacist, learning about drug dispensing and the challenges patients encountered with drug interactions, adverse events and drugs that simply did not work for certain people. In 2011, I set out to build the best laboratory services in the country. Today, ASCL is a state-of-the-art lab that reflects my mission to provide the highest quality of testing, expedient delivery of results, and superior customer service to clients throughout the United States. Our business philosophy is to stay ahead of innovations in toxicology and pharmacogenomics as the future of medicine.

We remain focused on turning around tests quickly and accurately, while being affordable and accessible to everyone, physicians and patients alike. My passion for this business continues to grow – reinforced by such headlines as the recent story about 33 people who died from overdosing on synthetic marijuana in Brooklyn, my home territory. This rash of drug overdoses and spotlight on opioid abuse has underscored our driving strategy to give communities and individuals greater access to toxicology testing.

How will you be positioned to compete with the large, high-profile lab companies?

Independent clinical laboratories specializing in clinical toxicology and pharmacogenetics, like ACLS, are the best option for accessing convenient, high-quality testing services and accurate, timely test results. In fact, smaller labs are more responsive, and feature improved scheduling opportunities, faster turnaround of test results, accurate reporting and more competitive pricing. This could make a vital difference for individuals in the U.S. and around the world who need addiction treatment.

Laboratory drug testing is critical for supporting clinicians, but with insurance costs on the rise, many of those suffering from addiction are unable to get full coverage for lab testing. Given the persistent and evolving introduction of new and highly dangerous drugs in communities, this kind of rapid drug testing as a primary prevention, diagnostic and monitoring tool can identify the presence or absence of drugs of abuse or therapeutic agents in multiple settings. Making lab testing more affordable and available across communities is essential for preventing drug abuse – and saving lives – especially among teens and young adults.

Why is toxicology testing becoming so important for both physicians and their patients?

The staggering statistics tell the story. Deaths from drug overdoses have risen in nearly every county across the United States, driven by an epidemic of addiction to prescription painkillers and heroin. The number of these deaths reached 47,055, a new peak, in 2014. In fact, the death rate from drug overdoses is climbing much more quickly than other causes of death. One report found that much of the increase in opioid dependence occurred since 2011. Patients ages 19 to 35 were most likely to be diagnosed as opioid-dependent compared to other age groups.

As for physicians, accessible, reliable, and rapid testing enables them to get the information necessary to achieve the highest quality care and outcomes.

We see that you have recently launched a healthcare advisory board. What was the motivation or inspiration behind this?

ACLS formed a Business Advisory Board composed of healthcare luminaries and thought leaders as part of our commitment to providing convenient, high-quality testing services. These leaders and influencers share our passion for ending the country’s heroin and opioid addiction crisis, and will help fuel our ongoing efforts.

Addiction to opioids and the use of street drugs, such as the K2, a synthetic marijuana, pose serious community issues that impact public health and social welfare, but clearly it is also a severe economic issue that affects everyone.

The primary diagnosis of opioid generates a number of medical services, including office visits, lab tests and other related treatments. In fact, the number of such services went from about 217,000 in 2007 to about seven million in 2014.

The Business Advisory Board will help spread this message among payers, healthcare providers and policymakers, who are well-advised to focus on insurance coverage that would enable these tests to be performed at smaller laboratory testing services.

As an entrepreneur, what would you say are the top three priority assets or skill sets needed to be successful in the global healthcare industry?

First of all, stay focused on innovation. Personalized medicine will be critical. This means being committed to finding the most optimal treatment regimen for each particular patient just by pinpointing the right drug at the right dose, for the right patient.

This ties into putting the patient first – the second important factor for success in the healthcare industry. This is essential across every area of healthcare. For example, our goal is to find the most effective and individualized balance at which a patient experiences maximum desirable analgesic relief and minimal undesirable adverse effects.

By initiating ongoing innovations for toxicology testing, labs like ACLS and others can implement more effective outreach, engagement, treatment, and coordination with the health and mental health systems and social supports.

Third, focus on the highest possible standards. For instance, ACLS is committed to medical research, quality and expedient testing that exceeds current standards of clinical toxicology because we want to do more than the bare minimum. We want to provide clients with the highest toxicology and clinical testing in the industry, including drug testing of urine and oral fluids, and pharmacogenetics for personalized prescribing. What we do matters. How we do it matters even more.

WKMJ has readers from over 10 countries globally. Please share your final words or thoughts with our readers. 

I’d like to emphasize the value of pharmacogenomics testing-- identifying how genes affect a patient’s response to medication. Genomic differences influence the efficacy of medication and can be the source of serious drug side-effects and increase the risk of drug-to-drug interactions. Pharmacogenetic testing is the alternative to one-size-fits-all drug prescribing, which can lead to potentially serious side effects, treatment failure and poor patient compliance.

Pharmacogenetic testing can also indicate which patients will be likely to experience adverse events with particular drugs — another application of particular interest to seniors, who often take multiple medications. Pharmacogenetic test results show how each particular medication is metabolized in the liver, providing each referring physician with a laboratory analysis of many of the patient’s liver enzymes.

Along with the analysis, ACLS offers a detailed pharmacist’s report that analyzes the patient’s medication list and notes how it could be altered, based on information provided by the genomic test. People with certain genotypes have increased risk of life-threatening bleeds when introduced to the blood thinner warfarin or when dosages are changed. A dosing algorithm based on the patient’s genotype can potentially thwart this risk.

Research has shown that maintaining steady levels of opioids contributes to pain relief, but patients metabolize pain medications at different rates. Slow metabolizers of opioids may sustain dangerously high levels of opioids in the body, resulting in adverse events. Personalized knowledge of a patient’s metabolism patterns may assist in dosing.

Furthermore, pharmacogenetic test results may assist pain physicians in demonstrating that a particular patient requires a higher medication dose to experience pain relief. For example, for an ultra-rapid metabolizer, typical doses may not control pain for high metabolizers, who run the risk of being labeled abusers.

September 5, 2016

Leon Reyfman, M.D., FIPP, RpH

Chief Executive Officer, ACLS

Dr. Reyfman, chief executive officer, ACLS, is board-certified in Anesthesiology and Pain Management. He serves as director in Interventional Pain Medicine at Long Island College Hospital, and is assistant clinical professor of Anesthesiology at SUNY Downstate Medical School. Dr. Reyfman is a member of American Society of Interventional Pain Physicians, as well as the International Spine Intervention Society. He is actively involved in pain medicine research and teaching, has given multiple lectures in the areas of neuropathic pain, cancer pain, approach to diagnosis and treatment of lower back pain, and has extensive clinical experience and training in invasive and noninvasive pain management.