Commissioned by the Qatar Foundation, a nonprofit organization made up of more than 50 entities working in education, research, and community development, Doing well? Fulfilling the promise of precision medicine, "looks at the promise and current limitations of precision medicine, the barriers to its implementation in public health systems, and the areas where policymakers – indeed, all stakeholders – must focus their efforts in order to realize its potential."
The key findings listed below are based on an extensive literature review and a comprehensive interview program conducted by The EIU between March and September 2020.
- Defining the term precision medicine is challenging. It is best understood as the potential outcome of four interwoven, data-related enablers: (1) the increasing volume of data available to health systems; (2) vast growth in the kinds of data from which health systems can draw insight; (3) the increasing availability of data storage systems that permit easier access to relevant information; and (4) the quantum leaps in analytic technology that make it possible to draw greater insights from this information.
- Hopes are high. Precision medicine is expected to benefit all healthcare stakeholders: patients will have quicker access to the treatments they need, and will be able to avoid the risks of taking incorrect medication; health systems will reduce waste and improve outcomes; payers will receive better value for money; and the overall health of populations will improve.
- Current advances are limited but remain highly promising. There are already a number of important examples of precision medicine in action. Thanks to a better understanding of tumor genetics, more effective treatments are now possible for several cancers, notably those of the lung and breast. In the field of rare disease, genomic sequencing is cutting diagnosis times for a large number of patients. Pharmacogenomics—the study of how a person’s genetics interact with particular drugs—is a growing field, and genetic sequencing is being used to recognize pathogen mutations.
- Proof of value remains a pressing issue. Given the possible breadth of applications for precision medicine, it is challenging to determine whether the field as a whole is cost-effective. Some interventions may be; others may not.
- There is controversy around the concept of precision public health. This highlights fundamental issues that must be resolved if precision medicine is to become more widely integrated into health systems.
- Those seeking to incorporate precision medicine into healthcare systems will need to address a diverse and complicated range of issues. Innovation in healthcare systems is notoriously difficult. Integrating precision medicine into standard care will require the creation of new care pathways and new kinds of interventions, all of which will require different infrastructure. In most health systems, this process is only in the initial stages.
- To be successful, precision medicine must be delivered in a patient-centered way. Patient-centricity involves working with patients as co-creators of healthcare and health research, which involves a conversation of equals. Clinicians will need to help patients understand the implications of precision tests, the relevant data and the treatment choices. Both sides can then determine together what the patient values most in terms of the outcome(s) of any intervention. Adopting a patient-centricity can also helpto address some of the pressing ethical issues surrounding precision medicine.
The report's concluding paragraph insightfully notes: "We are still in the early stages of learning how to implement precision medicine and understanding what this will look like in practice. All relevant stakeholders need to ensure that they develop the appropriate and necessary foundations for precision medicine in order for this radically new way of doing things to deliver on its promises."
To complement its report, The EIU produced the video below (also viewable through this link) entitled "Can precision medicine fulfill its promise?"
What are your recommendations for how precision medicine can transform healthcare?
Aaron Rose is a board member, corporate advisor, and co-founder of great companies. He also serves as the editor of GT Perspectives, an online forum focused on turning perspective into opportunity.