One Size Doesn’t Fit All: Personalized Healthcare and Genomic Medicine

In many ways, personalized healthcare is nothing new. Doctors have always aimed to provide patients with treatments based on the variables that make each of us our own individual. They’ve long known that what may work for one person, doesn’t necessarily work for another. However, with the advancement of medical research and technology, physicians and medical professionals are taking personalized healthcare to an entirely new level. Every person is different, possessing different genes, living in a different environments and living different lifestyles.

Medical labels containing warning labels about risks for pregnant women, or commercials providing warning that a product should not be used by those with heart disease hint at a trend towards personalized medicine. By offering warnings, these medical companies acknowledge that their products will benefit most people, but not every person. For people with specific genetic makeups, they may actually cause adverse effects.

 

What is Personalized Healthcare?

Conventionally practiced healthcare is not as effective as it could be, according to a Genetic Alliance article. The difference between the past instances of personalization and the future of personalized medicine is that, “instead of assuming one treatment methods will work for everyone except a select few, we hope to begin with one persona and determine the treatment that is the best fit specifically for him or her,” according to a Jackson Laboratory article.

Personalized Healthcare can best be defined as “an emerging practice of medicine that uses an individual’s genetic profile to guide decisions made in regard to the prevention, diagnosis and treatment of disease, according to the Genetic Alliance. Personalized Healthcare takes into account patients’ individual characteristics and their diseases to improve medical outcomes and quality of care. In addition, it allows physicians to better predict which patients will likely benefit from treatment and helps them avoid treatment that is unlikely to provide benefit. Personalized Healthcare can also reduce the risk of side effects by aiding in the development of safer and more effective treatments. Overall, there is great potential to save more patients’ lives while also improving their quality of life.

 

Shifting Medical Emphasis from Reaction to Prevention

Personalized Medicine provides the ability to use molecular markers to indicate or signal disease risk or presence long before clinical signs and symptoms appear. This shift is an opportunity for physicians to focus on prevention and early intervention, rather than focus on reacting to various advanced stages of disease. While not every test is directly linked to a therapeutic treatment option, if a patient learns he or she has inherited a genetic heart condition like cardiomyopathy, they can benefit from suggested lifestyle changes and disease monitoring options to avoid risk of sudden death, according to the Personalized Medicine Coalition.Picture2

 

Reducing Trial-And-Error Prescribing

Oftentimes, patients do not benefit from the first drug they are offered in treatment. In many cases, it takes multiple attempts to find the right medication for a patient. With the use of genetic and other forms of molecular screening, physicians can select an optimal therapy the first time, avoiding the frustrating, costly and potentially life-threatening practice of trial-and-error prescribing, according to a recent study by the Personalized Medicine Coalition.

With the multitude of drugs available, it dramatically improves the quality of patient care when doctors can say, this drug is not for everyone, but it is for you. “An inexpensive genetic test can reveal the risk and allow physicians to craft an alternative course of treatment, such as the administration of the drug Effiant (prasugrel), which helps prevent stroke or blood clots in patients who have undergone cardiac surgery, have had a heart attack, or have an implanted stent,” the report read.

 

Avoiding Adverse Drug Reactions

As I mentioned earlier, prescribing the wrong medication can be potentially life threatening for patients. However, according to the FDA, progress when it comes to developing and adopting diagnostics to determine which medications work best for which patients in order to reduce adverse events has been slow. In fact, between 2000 and 2011, the number of adverse events recorded by the FDA nearly tripled.

A number of recent studies found that about 5.3 percent of all hospital admissions are associated with adverse drug reactions (ADRs), according to the Personalized Medicine coalition. Why does this happen? One reason is that variations in genes that code for drug-metabolizing enzymes cause drugs to be metabolized at different speeds. This can cause some individuals to have trouble “inactivating a drugs and eliminating it from their bodies, leading to ‘overdose toxicity,’ others eliminate the drug too rapidly before it has had a chance to work. If these genetic variations are not considered when dosing, the consequences can range from unpleasant to fatal.”

 

Concerns About Personalized Healthcare

While there are plenty of benefits to personalizing healthcare, there are also a number of potential drawbacks that should be addressed. First, protecting patient privacy is one of the most important things that must be accomplished. Most people agree that patients have the right to keep their personal details and health information private from most people. The question is: Where do we draw the line? How far should that right go?  Should it extend to a covering a person’s genetic makeup? Some medical professionals are concerned that, if a person has genetic information collected for use in profiling or diagnosis, should that then automatically commit them to allowing their data to be used for diagnosing and profiling others? Genetic information is, technically, personally identifying, meaning that it can never truly be anonymous.

Another issue is patient autonomy, which relates to the patient’s right to choose what happens to them and whether or not they should be required to allow their data to be used for risk profiling or diagnosis as a condition of performing the service for them. While large sample sizes are needed for high quality risk prediction, is it too much pressure on a person to require that they provide their genetic information? Is a patient’s autonomy a greater ethical requirement than society’s right to maintain efficient and effective care, or a payer’s right to avoid unnecessary cost burdens? These are the types of ethical questions that must be raised and addressed appropriately to ensure personalized medicine improves patient care quality, rather than take away from it.

Integrating personalization a health system is no easy task. To do it effectively, it’s important to have the right forward-thinking team that understands the nuances of this new and exciting trend in healthcare. If you’re looking to build your next healthcare team, contact us or call us today at Healthcare Recruiters International. Our executive recruiters focus on recruiting for Biotechnology, Pharmaceutical, Pharmacy and more.

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