Big Ideas: Precision Medicine: Balancing the Promise and Pitfalls
From the president to your next door neighbor, people are increasingly aware of and excited about genetic medicine. But how should hospitals get involved?
This article first appeared in the December 2016 issue of HealthLeaders magazine.
Whether you call it precision medicine, personalized medicine, genetic medicine, or by a term yet to be coined, decoding DNA has begun to revolutionize the practice of medicine. In many instances, the science exists to quantify an individual's predisposition for a specific disease or target a precise mutation within a tumor's own genes.
The promise of such advances is so powerful that President Barak Obama earmarked $215 million of the country's 2016 budget to the Precision Medicine Initiative, intended to accelerate the development of new genetically based tests, tools, and treatments.
And the majority of U.S. adults are interested in being part of these discoveries, according to a study funded by the Foundation for National Institutes of Health. The study, published by PLOS ONE, revealed 79% of those surveyed support the idea of a national cohort study, while 54% would definitely or probably participate if asked.
What individuals crave even more, it seems, is insight into their own genetic profile, which can be bought for as little as $199 and some spit. The cost of full genome sequencing is now around $2,000, a modest expense compared to the $100 million it cost in the not-too-distant past.
Expanse of the unknown
But for all of the enticing questions genetic research can currently answer, it raises exponentially more.
When it comes to any genetic test, the healthcare community has before it two key questions, according to Lawrence Brody, PhD, director of the division of genomics and society at the National Human Genome Research Institute (NHGRI): "Do they enhance outcomes and do they make healthcare essentially more effective?"
"I think that's the bar most of us in our institute would like to be able to test," he says. "We're at a very intense phase of research where we're trying to figure out what we can learn in regard to treating patients and potentially in regard to preventing them from being patients in the first place."