Personalizing health care: feasibility and future implications

Abstract

Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer’s perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients.

Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study

“…This inappropriate drug use has serious health and economic influences for the success of national health care system. The irrational use of medicines is a worldwide problem increasing morbidity, mortality and costs through increasing adverse drug reactions and hence patients are not achieving their desired outcomes [13, 14]. …”

DNA Topoisomerase I Gene Copy Number and mRNA Expression Assessed as Predictive Biomarkers for Adjuvant Irinotecan in Stage II/III Colon Cancer

“…9). A limitation of systemic therapy is the great interpatient variability in drug efficacy and severity of adverse effects (10). In the pursuit of a more personalized treatment approach, it is clinically important to identify tumor characteristics that may serve as biomarkers which will accurately predict the likelihood of benefit in advance of therapy.…”

Economic Evaluation of Pharmacogenomics: A Value-Based Approach to Pragmatic Decision Making in the Face of Complexity

“…In addition to informing further investment in technology research and development, these include guiding the focus to address specific indications or patient groups, clinical trial data collection needs for specific parameters, and making the business case for risk stratification [3]. Generating evidence at this early stage will facilitate funding of new technologies that improve diagnosis, prognosis or subsequent care, especially in the presence of concern among payers when faced with premium prices for new targeted treatments [25,26]. Good candidate technologies include those targeted at improving patient outcomes and reducing costs through identification of which patients will benefit more from effective high-cost treatments or surveillance for diseases with high morbidity or mortality.…”