Precision medicine involves tailoring medication to patients’ individual genes. While this may sound like science fiction, it is on the way to becoming scientific fact. In New York, top tier, nonprofit research facilities are building gene-pool exploration centers for what some call the latest “medical arms race.” The DNA combatants include Icahn School of Medicine at Mount Sinai, Weill Cornell Medical College and New York-Presbyterian Hospital/Weill Cornell Hospital, and the Memorial Sloan-Kettering Cancer Center.
Advocates for precision medicine believe that the complete sequencing of patients’ gene-pools will become an everyday proven necessity. Others are not so sure.
Having risky DNA sequences does not guarantee the development of diseases. Lifestyle and environment have important effects on disease. To that end, Johns Hopkins is studying how toxic exposures in patients’ everyday environments may trigger risky DNA sequences. Additionally, the US government’s research grants for precision medicine will fund worthiness studies.
What is the cost of precision medicine?
Some Harvard researchers are studying whether precision medicine can reasonably be considered practical, while others are researching diseases where the method might be used. Until there is more definitive information, your health insurance company is unlikely to contribute much for precision medicine assessments. The cost to assess the entire sequence of a person’s DNA is between $5,000 and $10,000, and analysis of the sequence is extra. Also extra are some of the newer medications that the sequencing may select. Some of these are significantly more expensive than standard therapies but have yet to prove significantly longer survival benefit.
Mainstream acceptance of precision medicine requires validation. Researchers must produce multiple, large-scale, human studies proving that the approach can correctly identify patients who will benefit from atypical medicines. Funding for these billion dollar projects will largely come from the government and from pharmaceutical companies (meaning they will own the human data and the results). Outreach needs to be done in order to gain participation from patients who have the target diseases and/or who are likely to have the disease markers in their DNA.
Handing over DNA has far-reaching implications for patients, their families, and all of their descendants. Additionally, we need to develop new technology for tracking, trending, and analyzing human DNA. Most importantly, in order for precision medicine to be considered worthwhile, its application must result in the beneficial use of existing atypical medications or in the rapid production of such medicines. Otherwise, what is the point?
References
Bekiempis V. Mount Sinai Medical Center opens new high-tech research facility. DNAinfo.com New York Neighborhood News. Published 12/13/12.
Hartocollis A. Cancer centers racing to map patients’ genes. The New York Times: Health. Published 4/21/13.
Mirnezami RJ et al. Preparing for precision medicine. The New England Journal of Medicine 2012; 366:489-91.
Zimmer A. Medical arms race’ spurs massive health development on East Side. DNAinfo.com New York Neighborhood News. Published 1/18/12.
