The future of precision medicine
Posted 7th June 2017 by Jane Williams
Unreasonable cost of trial-and-error medicine means precision medicine is imperative for targeted therapies
Rising pressures to decrease healthcare cost globally, the emergence of value-based reimbursement models and healthcare digitisation trends are transitioning the medication model from ‘one-size-fits-all’ to stratified and outcome based targeted therapies.
Nature estimates 90% of the conventional and top selling blockbuster medicines only work for 30% to 50% of patients. What is worse is the side effects and adverse reactions caused by these imprecise medications account for 30% of acute hospital admissions every year. Today, the drug development industry is betting big on precision medicine. Leading pharmaceutical and biopharmaceutical companies have nearly doubled their investment in personalised medicines in the last 5 years, and expect an additional 1/3 increase in the next 5 years.
Adoption of genomics data into clinical workflow will create learning health systems with a similar trajectory to EHR systems
Unique to precision medicine is the integration of omics/genomic data into the clinical workflow to derive deeper insight into genetic and chronic diseases. Today, innovative companies such as IBM Watson, N-of-One (a molecular decision support system provider) and 2bPrecise LLC (an Allscripts company) are coming up with advanced clinical decision support solutions that are capable of combining genomic data with clinical and lifestyle data to bridge the last miles for precision medicine practice. Integration of these genomics data into the clinical workflow will create learning health systems with a similar trajectory to that of EHR systems and will be eventually widespread in the next 3 – 5 years albeit at varying degrees across different countries.
Precision Medicine focus goes beyond omic-factors
Precision medicine will harness healthcare big data to elevate preventive care for chronic disease management. As care for these chronic diseases expands in scope, prevention and recovery are becoming the new focus areas, alongside diagnosis and treatment. This demands a holistic view of individual health, lifestyle and environmental data beyond the clinical health records to efficiently stratify at-risk patients for a preventive and targeted treatment paradigm. Today, there are many innovative digital health coaching platforms and wellness programmes with proven behavioural therapies such as Omada (digital behavioural therapies for diabetes patients), and Zipongo (personalised nutrition solutions) finding their way as efficient alternative therapies for prevention and management of acute chronic health conditions.
Critical challenges questioning the future of precision medicine
- Precision medicine will be prohibitively expensive for next 3-5 years in a cost-conscious and competitive healthcare delivery landscape.
- The current legal and ethical frameworks both at global and regional levels were built with a very different generation of medical products and practices in mind and raise some serious challenges for the revolutionary concept of precision medicine practice.
- The industry needs more and better precision drugs, beyond Federal Investment stimulus and advancement in diagnostic technologies.
- Precision Oncology is still a hypothesis that needs further verification – mutations may be different at different places in a tumour restricting the administration of a precision drug to relatively small target specific mutations.
Dorman Followwill is a Partner at Frost & Sullivan. He has played a leading role in some of the largest consulting engagements in the history of the firm, including work with Bayer Biologicals and Philips.
Network with senior representations of leading pharma and biotech companies at the 4th Global Precision Medicine & Biomarkers Leaders Summit. View the agenda.
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