Personalised medicine – isn’t medicine always?
Let’s assume that you have symptoms of a condition, and it is likely that a reason for the symptoms can be found. In order to find the reason, you book an appointment at a physician’s practice. At the practice, the physician examines and evaluates your symptoms, vital functions and state of health. You may also have some tests made. The physician aims at diagnosing the condition you are suffering and at treating you in accordance with the symptoms and the determined diagnosis. The physician will target all expertise in order to treat specifically you and your case. You feel that you receive individualised, tailor-made treatment for you personally, which helps alleviating your symptoms and curing the condition in question, in the best case.
Actually, you are only partly correct, since probably the treatment selected for you is not based on your individual characteristics, which are determined by your genes and adjusted by your life style and environment. It is also likely that the treatment is not based on the special attributes at the molecular level of the condition you are suffering. Instead, it is most probable that your treatment is based on a conception of the general effectiveness of the selected treatment in the normal patient group with the particular condition. It is likely that your physician would select the same treatment for any patient with the same condition, with a general state of health and basic characteristics similar to you. You receive treatment, which is roughly speaking based on “One size fits all” perception and thus is most plausible to work for a typical average patient with the particular condition. You probably do not even ask your physician how likely it is that the treatment works specifically for you? And that is great, because your physician is unlikely to have a correct answer to the question. You accept the standard treatment selected for you, since it is the best available treatment in average terms. Unfortunately, sometimes finding a treatment that suits you specifically can only be found after trials and failures.
Personalised medicine is already here!
We have already seen examples of medicine becoming more targeted especially in the treatment of cancer, where some of the utilised treatments are selected on the basis of the individual genetic qualities of the patient and of the special attributes of the condition at the molecular level. The power pushing the change forward is the pursuit to achieve better response, minimize adverse effects caused by treatments and to control treatment costs. The new direction in medicine is called personalised medicine, precision medicine or genomic medicine. It takes into account in a new manner your true individual attributes and risks, written in your genes and adjusted by your life style and environment. Currently, the technological development enables a new type of consideration of genes in medical treatment decisions, with little over a decade after the entire genotype of human was revealed in the Human Genome Project. Transformation is on with an accelerating pace, and it will change the prevention, diagnosing and treatment of diseases. Collecting the material received from patients in biobanks and the increasing utilisation of the material in the research on targeting new treatments will be part of this change.
Transformation is ahead in the field
The transformation will also impact the operational modes of pharmaceutical producers. The development from One drug fits all -concept to targeted treatments for selected patients will change the earnings model of pharmaceutical companies. New molecules apply to a more limited target patient profiles, which creates new challenges for pricing medicinal products. The basic assumption will, however, remain: pharmaceutical companies will have to be able to earn the development costs of the product during the lifecycle of the product. The change of the earnings mode is already visible in the pricing of new targeted medicinal treatments. Those who pay for the medicinal products face a new situation and the evaluation of the cost-effectiveness of treatments will be even more important. It is justified to expect better treatment results with a higher price, preventing the outbreak of complications, which are the most expensive to treat.
There will probably be no actor in healthcare who does not need to react and adapt to the consequences to be caused by the above-mentioned big changes in the following decade. Preparation is easier when you know what to expect.
Do you want to know more?
Medaffcon organised an expert event discussing the presented issues in the beginning of April 2016. In the event we visualised the changes ahead in the healthcare operational environment, which will have significant consequences for the actors in the field. Content from the event will be available in Medaffcon’s website during April and May.
The same topic was discussed in A-Studio on 19 January 2016. Listen to the debate (in Finnish) by clicking the following link. http://areena.yle.fi/1-3062167
Sr Scientific Project Manager
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