Putting patients first

Published: Wednesday, March 12, 2014, 9:00p.m. Updated 7 hours ago

Individualized treatments tailored to patients' particular genetic makeups is the future of health care. That's what personalized medicine means. Extraordinary advances in biopharmaceutical research will result in a doubling of the market for personalized medicines by 2019, to more than $18 billion. Nearly half the prescription compounds currently in development are individualized therapies.

Targeted treatments save lives, minimize side effects, prevent illnesses and more effectively and efficiently restore health to the sick. But these exciting developments are threatened by recent policy efforts to contain short-term health care costs that sacrifice long-term individual patient outcomes.

Researchers understand the potential of personalized medicine. A recent report from the Tufts Center for the Study of Drug Development found that 94 percent of biopharmaceutical companies are developing personalized medicines. Between 2006 and 2010, their investments in this area increased by 75 percent.

Today, cutting-edge treatments are helping patients fight cancer, diabetes and heart ailments. Scientists have discovered the genetic links behind more than 50 hereditary cancer syndromes. For America's 1.2 million HIV/AIDS patients, new capabilities allow doctors to customize drug cocktails based on the patient's biological characteristics, eliminating many side effects and greatly improving quality of life.

Personalized medicine has been especially effective in treating so-called orphan diseases, rare illnesses that each afflict fewer than 200,000 Americans. But, as a whole, the nearly 7,000 orphans take a significant toll on our country's health.

Unfortunately, Uncle Sam has launched an initiative that could undermine the potential of individualized medicine for decades to come. In the name of cutting costs, the federal government is funding comparative effectiveness research studies to calculate the average impact of different therapies across broad swathes of the population. By de-personalizing medicine and endorsing limited treatment options, the rationale goes, policymakers can cut expenses across the system as a whole.

The problem, of course, is that what works for the average patient isn't always the best course of treatment for any given individual.

The pressure on physicians to make their prescription selections based predominantly on comparative effectiveness research is mounting fast. Proponents have even suggested that recommended drugs be reimbursed at higher rates, while newer, more personalized medicines get short shrift.

Tinkering with the reimbursement system would likely create a conflict of interest for doctors. Ignoring the best interest of the patients, physicians would have a strong incentive to prescribe the medications that win the bureaucrats' seal of approval. This approach will have a chilling effect on innovation, as researchers realize they may have little hope of seeing a return on their intellectual investment.

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Putting patients first

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