Personalised healthcare stands at the confluence of the most powerful technologies in the history of the life sciences.
These include genomics and the prospect this embodies of carrying out – and applying – personal genome sequencing to choosing a suitable treatment. They encompass imaging, microfluidics and other diagnostic tools that will enable point-of-care identification of genes and other biomarkers. And they include computer systems and associated communications networks and embedded devices that will make it possible to organise, interpret and interrogate this information and apply it to tailoring medical treatment.
Downstream from personalised healthcare 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 manage these costs by improving treatment, enabling people to monitor their own health, increasing compliance, and providing inputs and an intellectual framework for the development of drugs for hitherto untreatable diseases such as Alzheimer’s. No one is suggesting that treatment is not already personal, in that healthcare professionals make an assessment of patients before deciding on how to treat each of 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 in the discovery phase to spot drugs that have toxic effects on the liver, heart or kidneys, or to select a clinical trial population where all the subjects express the biomolecular target at which a particular drug is aimed. It follows that personalised medicine also offers the hope of avoiding the product recalls, warnings on labelling and lawsuits that ensue after serious adverse reactions to drugs.
So this is a very powerful technology, indeed.
Then why isn’t everybody using it right now?
That is the question that Science|Business has been studying for the past year, in association with researchers at Stockholm’s famed medical university, Karolinska Institutet, and a consortium of industrial, non-profit and professional partners. The story of personalised healthcare is a classic case of the difficulties of getting a hot new technology from lab to market. Specialists in the field agree: It is powerful, important, destabilising, disruptive. But a host of problems slow its deployment into mainstream medicine.
These problems are varied. They include imperfect understanding of the basic science, difficulty identifying biomarkers and related tests, and a drug-approval process geared more towards an old-world, ‘blockbuster’ model than to a new age of tailored treatment. The problems go on: Inadequate financing, inflexible payment systems, uncertainty over how to use – while still protecting – the reams of patient data this technology will produce. Then, in Europe, add the problems of a fragmented healthcare system – carving up the available markets into uneconomic parcels, and adding layers of costly administration. Finally, there is ignorance: Even where personalised treatments exist today, how many doctors actually understand their potential, application and administration?
This report includes the results of a survey by Karolinska and Science|Business gathering the views of stakeholders in Belgium, France, the Netherlands and the UK with an interest in personalised healthcare , to get an overview of the issues that are at stake and the barriers to deploying personalised medicine across Europe. This is the first such, multi-country study of medical opinion leaders conducted – and provides unique insight into the problems.
We at Science|Business, a London- and Brussels-based media company formed to focus on getting new technologies from lab to market, will be continuing our work in this field – in our daily online news reports, and in a series of conferences.
Our aim: By highlighting the problems, we can get solutions.
Our future health depends on it.