Precision Medicine : From Ready-To-Wear To Taylor-Made

By Martin Leboeuf, Ph.D., Tarmes Capital Inc.

Pharmacogenomics, pharmacogenetics, precision medicine, personalized medicine: terms often used interchangeably to talk about the tailoring of disease prevention, diagnosis and treatment for individual patients based on their uniqueness. The goal is better patient outcome, along with cost reduction and better overall efficiency of the healthcare ecosystem.

A recent joint report by SAP and Oxford Economics shows that precision medicine is already having sizeable impact on patient outcome, and that this revolution, as they call it, will attain maturation within the next two years.

The main conclusions of their survey of 120 healthcare professionals, all with meaningful focus on personalized medicine, are

• early results are promising, and aspirations are high : two thirds of respondents say personalized medicine is having measurable effect on patient outcome and that it will have an impact on their organization in the next two years;
• a new approach to healthcare demands meaningful adjustments to culture and governance. Most organizations are still learning to share data and interact with newly empowered patients, while preparation for regulatory changes remains a work in progress;
• technology is at the heart of the shift to personalized medicine : substantial investments in Big Data and analytics are much needed and already ongoing;
• while business models are not fully developed, the economic case for personalized medicine is maturing with revenue growth and profitability expected over the next two years

The shift towards precision medicine       

The ever increasing role of precision medicine does not mean the end of the traditional, mass-market model, neither does it mean that other approaches, such as population health, will be replaced by it. But as the Cancer MoonShot 2020 Progam or the Precision Medicine Initiative demonstrate, the precision medicine revolution is well under way. Precision medicine can also be used to segment populations into subgroups, and treatment for a patient will be determined based on which subgroup he or she belongs.

Precision medicine benefits reach beyond better patient outcome, as reported in the survey : “tailored treatment plans help reduce wasted resources, time, and expenses, and ultimately help move people through the healthcare system more rapidly”.

A change in culture and governance

The very nature of personalized medicine raises new privacy issues. Because genetic information makes it possible to identify patients, new privacy protection rules and regulations have to be put in place. And these rules have to be designed in such a way that they are applicable under many jurisdictions and different environments (clinical, research, institutional, etc.)

Personalized medicine also means an unprecedented level of interaction with the patient at every step of the process. This essential, deeper involvement of the patient has to be recognized and encouraged.

The massive amount of data needed to make personalized medicine possible far exceeds what single institutions can gather. Hence, data need be shared amongst research scientists. This calls for a major change in the still widely spread culture of secrecy.

Technology is enabling precision medicine

These immense amounts of data pose equally immense technical challenges. Firstly, the sheer amount of data that need be captured and stored is in itself very demanding. And once the data is available, making sense out of it is an even greater challenge. As the SAP-Oxford Ecomonics report says : “Big Data analytics, capture, and storage are top areas of investment for the next two years. Tools that will take the process one step further—like data-sharing and collaboration technologies—are the next area of focus

Making the economic case for precision medicine

The increased efficiency provided by precision medicine allows physicians to see more patients without compromising on quality. Also, more efficient treatments mean reduced costs for health insurers. “In fact, improving efficacy of treatment, lowering costs, and improving time to market are leading forces driving personalized-medicine research”, according to the report.

As Joachim Reischl, PhD, vice president and head of policy, portfolio, and externalization for AstraZeneca’s personalized healthcare and biomarkers function puts it : “We are only seeing the tip of the iceberg. We can fundamentally change the way we run healthcare systems and, consequently, shift the economics of healthcare systems.”