Personalizing health care: feasibility and future implications.
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.
Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden. Brian.Godman@ki.se
Brian
B
Godman
Alexander E
AE
Finlayson
Parneet K
PK
Cheema
Eva
E
Zebedin-Brandl
Inaki
I
Gutiérrez-Ibarluzea
Jan
J
Jones
Rickard E
RE
Malmström
Elina
E
Asola
Christoph
C
Baumgärtel
Marion
M
Bennie
Iain
I
Bishop
Anna
A
Bucsics
Stephen
S
Campbell
Eduardo
E
Diogene
Alessandra
A
Ferrario
Jurij
J
Fürst
Kristina
K
Garuoliene
Miguel
M
Gomes
Katharine
K
Harris
Alan
A
Haycox
Harald
H
Herholz
Krystyna
K
Hviding
Saira
S
Jan
Marija
M
Kalaba
Christina
C
Kvalheim
Ott
O
Laius
Sven-Ake
SA
Lööv
Kamila
K
Malinowska
Andrew
A
Martin
Laura
L
McCullagh
Fredrik
F
Nilsson
Ken
K
Paterson
Ulrich
U
Schwabe
Gisbert
G
Selke
Catherine
C
Sermet
Steven
S
Simoens
Dominik
D
Tomek
Vera
V
Vlahovic-Palcevski
Luka
L
Voncina
Magdalena
M
Wladysiuk
Menno
M
van Woerkom
Durhane
D
Wong-Rieger
Corrine
C
Zara
Raghib
R
Ali
Lars L
LL
Gustafsson
D003695:Delivery of Health Care / Q000379:methods* / Q000639:trends; D005240:Feasibility Studies; D005544:Forecasting; D006801:Humans; D005791:Patient Care / Q000379:methods* / Q000639:trends; D010597:Pharmacogenetics / Q000379:methods / Q000639:trends; D057285:Precision Medicine / Q000379:methods* / Q000639:trends