Why precision medicine is not the best route to a healthier world

Abstract

Precision medicine has been announced as a new health revolution. The term precision implies more accuracy in healthcare and prevention of diseases, which could yield substantial cost savings. However, scientific debate about precision medicine is needed to avoid wasting economic resources and hype. In this commentary, we express the reasons why precision medicine cannot be a health revolution for population health. Advocates of precision medicine neglect the limitations of individual-centred, high-risk strategies (reduced population health impact) and the current crisis of evidence-based medicine. Overrated “precision medicine” promises may be serving vested interests, by dictating priorities in the research agenda and justifying the exorbitant healthcare expenditure in our finance-based medicine. If societies aspire to address strong risk factors for non-communicable diseases (such as air pollution, smoking, poor diets, or physical inactivity), they need less medicine and more investment in population prevention strategies.

Medicina de precisão/medicina personalizada: análise crítica dos movimentos de transformação da biomedicina no início do século XXI

“…Other researchers such as Coote & Joyner 10 and Prasad 11 argue that the promises have not been delivered and that it is unlikely that they will be. Together with other authors 12,19,28 , they see the emphasis on precision medicine as an error that will not lead to the development of a healthier world. Others still defend the undertaking, but see a need to change the way it is being led 34 .…”

“…Many authors 10,11,12,13 question whether personalized medicine/precision medicine is really a route to a healthier world.…”

“…One of the points in the debate on PM relates to its promises and its effectiveness in delivering applications that bring relevant benefits in the health of individuals or populations. According to many critics, the promises have been overblown and excessively optimistic (so-called "hype") 10,11,12,19,27,28 , given the large gap between the promises by researchers, pharmaceutical industry, and politicians in recent decades and the existing technical capacity to fulfill them.…”

“…Another questionable assumption is that PM will contribute to persons' adoption of preventive measures based on knowledge of their genetic susceptibilities. Several studies have problematized this claim and shown that genetic information with personalized orientation does not necessarily lead to behavior change by the persons at risk 12,22,35 . The low impact of actions targeted to high-risk individuals is a point frequently overlooked by defenders of PM 12 .…”

The Development of a Personalised Training Framework: Implementation of Emerging Technologies for Performance

“…Despite the potential promise of precision medicine, the approach has yet to fully reach its potential, and has been subject to a range of criticisms regarding its effectiveness [ 30 , 31 , 32 , 33 ]. Nevertheless, it remains a tantalizing proposition for the integrated health management of patients, and, as research progresses and challenges are overcome, will hopefully assist in the prevention and treatment of a number of diseases [ 16 ].…”