title: Digitization and its discontents: future shock in predictive oncology.
abstract: Clinical cancer care is being transformed by a high-technology informatics revolution fought out between the forces of personalized (biomarker-guided) and depersonalized (bureaucracy-controlled) medicine. Factors triggering this conflict include the online proliferation of treatment algorithms, rising prices of biological drug therapies, increasing sophistication of genomic-based predictive tools, and the growing entrepreneurialism of offshore treatment facilities. The resulting Napster-like forces unleashed within the oncology marketplace will deliver incremental improvements in cost-efficacy to global healthcare consumers. There will also be a price to pay, however, as the rising wave of digitization encourages third-party payers to make more use of biomarkers for tightening reimbursement criteria. Hence, as in other digitally transformed industries, a new paradigm of professional service delivery-less centered on doctor-patient relationships than in the past, and more dependent on pricing and marketing for standardized biomarker-defined indications-seems set to emerge as the unpredicted deliverable from this brave new world of predictive oncology.
authors.affiliation: Department of Oncology, St Vincent's Hospital, Sydney, Australia.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Epstein
mesh_terms: D000465:Algorithms; D014408:Biomarkers, Tumor; D004345:Drug Industry; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D010817:Physician-Patient Relations; D057285:Precision Medicine
chemical_list: D014408:Biomarkers, Tumor