The Rise of Personalized Medicine
Quote:The rise of personalized medicine
By Miles Wilson | 10/21/09 - 17:31
Cast an eye over the pharmaceutical industry, and one thing is clear to see: burdened by the downfall of the blockbuster drugs, R&D investments now need a new, key player. Step forward personalized medicine.
Earlier this year, worldwide professional services firm PricewaterhouseCoopers (PwC) published a report detailing how patient response rates to medicines "can be very low," often varying from as low as 20 percent to 75 percent.
While the findings are not strictly new, they do stand as a stark warning to the state of the current system being implored by pharmaceutical companies across the globe.
Already, few believe it is possible to make all drugs work for all patients all the time, and then there's the age-old issue of what happens when two people take the same medication and have completely opposing responses.
Of course, that's where personalized medicine comes in.
One-size fits all
New research suggests that, in order to really get a handle on personalized medicine - the development of drug therapies that have efficacy within narrowly targeted groups of patients, based on each person's genetically programmed reaction to the drugs - will rely heavily on both the development of new (and expensive) drugs and revisiting older and cheaper medicines that are already armed with existing generic knowledge.
Colin Palmer, whose is head of pharmacogenomics at Dundee University, explains how the pharma industry needs to "try and get rid of the one-size fits all approach to medicine. Instead, he says, the future of medicine lies in creating more effective drugs that are tailored to the individual.
Now, as the industry comes under increased pressure to to improve efficacy and safety - thereby making drugs more cost-effective - a study published just last week has found that common asthma drugs, such salbutamol - a popular inhaler medicine also known as Ventolin - and salmeterol - an ingredient in Glaxosmithkline's Advair, fail to work in patients with a certain genetic make-up. In fact, suggests the report, they may make the condition worse.
Personalized medicine isn't a totally new idea. Some companies already offer "geno-typing" services, which allow patients to send a DNA sample and - for a fee - they give you a typing for as many as a million genetic variants.
Of course, such information is only really useful when the ability to use it becomes available - but the hope is that that time won't be too far off.
Palmer and his team in Dundee, for instance, are already investigating the genes involved in defining whether a patient can respond well to statins - a class of drugs used by millions of people to try to lower cholesterol.
And scientists are also recommending that relatively cheap and easy tests, such as cheek swabs or blood tests, could be carried out to see whether a patient is likely to respond well to the medicine usually prescribed ahead of time, thereby closing the responses gap.
But the future of personalized medicine, and therefore its no-doubt critical role in the future of patient care, is possibly best summed up by Donald Singer, a professor of clinical pharmacology and therapeutics at the University of Warwick's medical school in the UK.
He explains how that, in the last 12 months or so, people have been beginning to find gene markers in much more common areas, noting that the industry is really on the cusp of understanding the cost effectiveness of the personalized approach.
"From the point of view of governments, testing and then going for the older off-patent drugs could be more cost-effective, rather than ploughing money into new ones," he added. "What we really want is for patients to go to their doctor, get a blood test which could lay out a genetic map, and then prescribe drugs based on the test results."
There are no others, there is only us.