It is 2038. You browse online pharmacy, you are kindly asked to scan a QR code and share your electronic health record including your prescription and your whole genome sequencing of course. It takes seconds for the algorithm to analyze all that data and suggest the pharmacist immediately which drug or supplement would be the most effective for you along with the precise dosage. At this moment, it may sound like a utopian future, but how far is the world actually from this scenario?
Does one size still fits all?
A one-size-fits-all approach usually doesn’t work, especially for complex systems like humans, which are influenced by genetics and the environment. However, when it comes to our health, we often have to rely on general methods and formulas created by modern medicine.
This type of healthcare may soon be outdated, as breakthrough in fields like genomics, bioinformatics, proteomics, and metabolomics are transforming medicine and leading us into a new era of personalised care.
SCIENCE IS A GAME CHANGER
Each time you go to a doctor you have your medical record updated. It can provide health care professionals with valuable data about your previous and current conditions and impact their decisions with regards to drug prescriptions, diagnoses and checkups.
Still, this information is very limited and does not take your genetics into consideration. But it might soon change.
Such evolving methods as genome sequencing and molecular diagnostics provide a much more detailed picture of who we are at the molecular level and as a result allow better to predict individual health risk factors, diagnose diseases early and design the most effective treatments for each person (1). These methods can fundamentally change our medicine, allowing to focus on prevention rather than reactive medicine or “sick care”.
We are not yet there though, as methods just mentioned are still being developed and requires more research. Expensive infrastructure and equipment are needed for that, as well as major funds to support the costly R&D process. There are also regulatory issues and data management concerns. But the future benefits of personalised medicine far outweigh these and are worth the challenges ahead.
FROM SICK CARE TO HEALTH CARE
By being more efficient, personalised prevention has the potential to detect diseases earlier when they are easier to cure, or to prevent certain types of conditions altogether. It can increase our life expectancy and help us live healthier, happier and higher quality lives. This type of future medicine also can be much more cost effective, because treating patients in the latter stages of illness with acute symptoms always requires more resources. That’s why initiatives like Nordic Health 2030 movement (2) promote a shift from reactive to preventative healthcare and see personalised medicine as instrumental for this transformation.
Methods and medicines tailored to individuals also prevent spending money on ineffective treatments. For example, the drug “Avastin” used in cancer treatment can cost up to 100 000 USD per patient per year, but it is only effective in fewer than 50% of cases (3). This means that a lot of recourses could be redirected to other areas if only it were known beforehand which patients the drug would truly work for. With pharmacogenomics and other methods individual response to a specific drug can be accurately assed and predicted, thus making treatment much more effective.
A simple example of the strengths and weaknesses of generalised medicine is the over-the-counter pain killer sold as Tylenol in the USA or Panadol everywhere else. It is taken by nearly 25% of US population every week, its active ingredient, acetaminophen, is the most common drug ingredient consumed in the United States. It helps hundreds of millions of people relieve their aches and pains.
This very popular and useful drug can occasionally be very dangerous: in USA alone, it is responsible for 56,000 ER visits, 2,600 hospitalizations and 500 deaths per year. Apparently, Acetaminophen, generally considered safe, can prove fatal even in small doses to a tiny fraction of people due to their unique pharmacogenomics (4).
BETTER TOOLS TO FIGHT HEART DISEASES AND CANCER
Almost all fields of medicine could benefit from the precise approach. Both cardiovascular diseases and cancer – which, according to World Health Organization (5), are currently the two leading causes of death globally – could be prevented and treated more effectively within the framework of personalised medicine.
Cardiovascular care could be improved with personalised medicine by assessing genetic risk factors and biomarkers (6). This could help in tailoring treatment plans, such as anticoagulant therapy, based on genetic variations in drug metabolism enzymes, thus enhancing risk stratification and prevention efforts.
The shift towards personalised medicine in cardiovascular diseases could also lead to significant cost savings. Preventing heart attacks and strokes could reduce the economic burden on health care system in reducing hospitalisations and emergency care costs. According to estimate calculations, optimising treatment based on genetic testing can save up to $3,000 annually (7).
Oncology is another major area that is being revolutionised by personalised medicine (8). It helps immensely by enabling the identification of specific genetic mutations and molecular alterations that induce tumor growth. Techniques like next-generation sequencing (NGS) and molecular profiling allow oncologists to select targeted therapies tailored to individual patients, significantly improving treatment response rates and survival outcomes.
THE FUTURE TO BE LOOKING FOR
Personalised medicine undoubtedly represents a major shift in healthcare. By tailoring medical treatment to the unique genetic, proteomic, and metabolic profiles of individuals, it enhances the precision and efficacy of interventions.
This approach not only improves treatment outcomes but also minimises side effects, as therapies are customised to align with a patient’s specific biological makeup.
Moreover, personalised medicine fosters early detection and prevention of diseases through advanced molecular diagnostics, potentially reducing the overall burden on healthcare systems. It also opens new avenues for innovative drug development and targeted therapies, thereby accelerating the transition from a one-size-fits-all model to a more patient-centric approach.
In the end, bringing personalised medicine into routine clinical practice could not only enhance our quality of life but also create a more efficient and fair healthcare system. That’s the future we should aim for, and we need to invest the right resources to make it happen.
REFERENCES AND NOTES
- Monroe J. Personalised Medicine: The Future of Healthcare. The Jerusalem Post (online). 2024 Jan 2 (cited 2024 Jul 22). Available from: https://www.jpost.com/insights/article-780462
- Nordic Health 2030 (online). Copenhagen: Copenhagen Institute for Future Studies; (cited 2024 Jul 22). Available from: http://nordichealth2030.org/
- Glorikian H. The Underappreciated Cost-Saving Potential of Personalised Medicine in Health Reform Debate. Genetic Engineering & Biotechnology News (GEN) (online). 2009 Oct 8 (cited 2024 Jul 22). Available from: https://www.genengnews.com/insights/the-underappreciated-cost-saving-potential-of-personalised-medicine-in-health-reform-debate/
- Karelina M., Noh J. J., Dror R. O. How Accurately can one predict drug binding modes using AlphaFold models? eLife (online). 2023 (cited 2024 Jul 22); 12 (RP89386). Available from: https://doi.org/10.7554/elife.89386.1.
- World Health Organization (online). Geneva: World Health Organization; (date unknown). Fact sheets: Cardiovascular diseases (CVDs); (updated 2021 Jun 11, cited 2024 Jul 22). Available from https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
- The Lifesciences Magazine (online). San Jose: The Lifesciences Magazine; (date unknown). Personalised Medicine: Revolutionizing Healthcare Through Tailored Treatment; (cited 2024 Jul 22). Available from: https://thelifesciencesmagazine.com/understanding-personalised-medicine/
- Melillo, G. Assessing Cost Savings, Waste Reduction From Pharmacogenomics and Precision Medicine (online). Cranbury, NJ: The American Journal of Managed Care®; 2022 May 11 (cited 2024 Jul 22). Available from: https://www.ajmc.com/view/assessing-cost-savings-waste-reduction-from-pharmacogenomics-and-precision-medicine
