What is it?
Precision medicine, also widely known as personalised medicine can be described as a medical model with customisation of care as the focus, where medical treatments and products are tailored to the individual. Precision medicine recognises that personal genetic, environmental and lifestyle factors are key drivers in both the causes and ability to overcome a disease and hence tailors the approach to care with these factors in mind.
What’s behind this trend? The human genome project
, an international landmark study in the biosciences facilitated by technological advances in the field of genomics mapped the human genome. The understanding gained from this project on human genetic diversity has led to greater realisation of the potential for individualised healthcare. To add, the rise in preventable chronic conditions such as diabetes and cardiovascular diseases has caused great public interest into how these conditions can be avoided. Following this, the US has seen as increase in personalised medical practices like functional medicine, providing care through a revised medical approach. A major tenet in functional medicine is to focus on the individual and the underlying factors shaping their health and disease state.
How is the commercial sector responding?
Within industry a range of enterprises have emerged with the personalisation of health and the empowerment of the consumer at the core of their product or service: 23andMe
is a biotechnology company that creates home-based saliva DNA tests, where customers can trace their ancestry including their risks for a range of genetic diseases such as Alzheimer’s. Thriva
is a UK start up providing subscription services for finger-prick blood test to measure baseline health values, including cholesterol, liver function, vitamin D, B12 and iron levels. Most of their clients are currently based in London. Viome
is an ambitious company with the aim of creating a world where illness is optional. Their key service can be defined as microbiome and metabolic testing where their artificial intelligence engine analyses stool samples providing actionable nutrition and lifestyle recommendations, from identifying the species of bacteria residing in your gut to how effectively you metabolise macronutrients.
How is the public sector responding?
Just this year RMIT University researchers created an ingestible pill
which senses gas levels in the digestive system with the potential to revolutionise the diagnosis and prevention of gut disorders such as Irritable Bowel Syndrome. The new technology could evade the need for more expensive procedures such as colonoscopies. To add, the all of us research programme
by National Institutes of Health, directed by Francis Collins MD PhD, seeks to ‘accelerate health research and medical breakthroughs, enabling individualized prevention, treatment, and care for all of us. ’ The programme which will enrol one million or more volunteers, aims to enable research into several disease areas and increase our understanding of healthy states. They will explore mHealth technologies, pharmacogenetics and overall empower participants to improve their own health.
The future of personalised care
Precision medicine carries weighty implications across a vast range of therapeutic areas, from diseases of the gut to cancers. With non-communicable diseases being the leading cause of death and disability worldwide and projected to grow in both high and low-income countries, coupled with the failure of some conventional therapies to effectively deal with the scale of the crisis, precision medicine offers a novel approach to the both the prevention, management or treatment of these conditions. An initiative which will investigate the future of this exciting area is the World precision medicine congress
taking place on the 16th-18th May 2018 in London, UK. The congress will explore the precision medicine pipeline including drug discovery and development, implementation in the clinic, ethical and regulatory considerations, and patient involvement. Senior executives, clinicians, academics and key opinion leaders in the field will be presenting. The congress will also include discussions on the use of technology in genomic medicine, patient data management and the expansion of artificial intelligence in healthcare. As with all technological innovation, and especially in the delivery of care, there will need to be caution in implementing new methods and procedures to ensure that quality remains central. Are we too captivated by precision medicine?
UK-based General Practitioner Margaret McCartney writes in the BMJ addressing some concerns at the rapid pace of innovation. Nevertheless, with the emergence of researchers and funders across disciplines, precision medicine will no doubt be coming to the forefront of medical services. How will your
organisation evolve to meet the expectations of future patients?