Richard L. Hudson, Editor, Science|Business
Personalised medicine stands at the confluence of the most powerful technologies in the history of the life sciences. These range from genomics and the prospect this embodies that it will soon be realistic to carry out - and apply - personal genome sequencing to choose a suitable treatment; to imaging, microfluidics and an array of other diagnostic tools that will enable point of care identification of genes and other biomarkers; and on to the computer systems and associated communications networks and embedded devices that will make it possible to organise, interpret and interrogate this information and apply it tailor medical treatment.
Downstream from personalised medicine lie the floodplains of old age and chronic disease, and their associated individual, social and financial costs. The promise is that personalised medicine can help to manage these costs by improving treatment, enabling people to monitor their own health status, increasing compliance, and providing inputs and an intellectual framework to develop drugs for diseases such as Alzheimer’s that are untreatable currently.
One simple example: a relatively attainable saving from personalised medicine that carries significant financial and health benefits, would be to stop giving people drugs they can’t metabolise because they don’t produce the right enzymes.
No one is suggesting that treatment is not personal now, in the sense that healthcare professionals always make an assessment of an individual patient before deciding on how to treat them. But the tools of personalised medicine will provide far deeper insights, erasing the need for a trial and error approach to treatment.
Early examples of this exist in cancer treatment, where a number of products now come with companion diagnostics.
We are also getting a preliminary view of how the biomarkers that are at the heart of personalised medicine could inform drug discovery and development, by making it easier to spot drugs that have toxic effects on the liver, or heart or kidneys, in the discovery phase, or to select a clinical trial population, knowing all the subjects express the target at which a particular drug is aimed.
It follows that personalised medicine also offers the hope of avoiding the recalls, restrictions to the labelling and law suits that are the consequence of serious adverse reactions to marketed drugs.
Personalised medicine is also starting to provide pharmaceutical companies with the means to demonstrate the added value of innovative drugs, giving them a way of finessing reimbursement negotiations and also confronting the cost benefit analyses of health technology assessment agencies.
There is much at stake here and as yet the reality is not matching up to the promise.
But one thing is certain: the antique model of one treatment fits all must be upgraded. Europe needs to move now to capture the benefits of Personalised Medicine.
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