Societal impacts of Personalised Medicine
The President talks about the societal shift that we call personalised medicine.
If personalised medicine is best known in its scientific and medical definitions, if personalised medicine is often addressed within regulatory and market access fora or in the context of drugs and associated diagnostics economic modeling, we cannot ignore that personalised medicine risks upsetting considerably our current healthcare systems and bodies in the next ten years.
We are at the dawn of a deeper mutation of our practices
Certain practices of targeted medicine have long existed. Models like Herceptin-Herceptest constituted the foundations of modern personalised medicine. Then, the development of molecular tests or mutation researches proliferated over these last years. Nevertheless, I trust that we are at the dawn of a deeper mutation of our practices.
The molecular definitions of pathologies do multiply, creating sub-types of pathologies and opening the door to a new classification of rare and orphan diseases. Researches in systems biology and metagenomics will reveal new mechanisms underlying pathologies previously untreated or poorly controlled by symptomatic and non-specific treatments.
New groups of diseases will be defined in the future, sometimes concurrently with their targeted therapy. Scientific research, growing exponentially and supported in this by the considerable capabilities of computer tools and new technology platforms, generate many future avenues for personalised approaches to medicine.
Cancer will not be the chosen field of personalised medicine as we now know. Infectious, degenerative, inflammatory, cardiovascular, metabolic diseases, without forgetting rare and orphan diseases, will soon benefit from the potential of personalised medicine.
A real societal upheaval of the 4Ps: Policies, Public, Patients and Healthcare Professionals
We must prepare ourselves for an influx of innovations which, given the amount of new information to be processed, will be a real societal upheaval of the 4Ps: Policies, Public, Patients and healthcare Professionals who make up an ecosystem.
This ecosystem is a whole. In a concern for equitable access to care, politicians and policy-makers need to anticipate, supervise and evaluate the innovations’ performances in light of what they will be expected to bring to citizens – patients and voters.
Patients, better and better aware of topic and well informed, will echo their expectations to health professionals, whose main challenge will be to train and absorb considerable amounts of information, and who in turn will head towards politicians and policy-makers for guidance and best practice recommendations.
It is interesting to note that we all spontaneously feel that personalised medicine will emerge as an innovation of mass disruption. Whatever the validation, regulation or market access procedures are, innovation is here. It will obtrude itself, whether on the current medical, regulatory and economic model, or carried by another model where the patient, empowered by intelligent tools, the critical need for good market access and information transfer, will invite oneself as an integral asset of the system.
What will be the societal impact? The one of historical breakthrough innovations; such as the treatment of infectious diseases that changed life expectancy and the age pyramid; such as the specific treatment of tuberculosis which not only cured diseases but also forced an overnight conversion of care facilities and personal care; such as the AIDS treatment that suddenly extended the life expectancy of people previously convicted.
Personalised medicine will not concern specific cases. Its breakthrough innovation will potentially be more massive by impacting the wider society at the expense of some existing systems of care, whether at patient, care organisations and caregivers, new jobs creation or new centers of excellence levels.
Access to information or control of it, shared between the patient and the caregiver, will change the reports hierarchy. The specialisation of excellence centers will change the role of tomorrow’s doctor, a profession already in turmoil.
Let’s ask ourselves some questions: what will be the physician’s role in this system?
What will be the players’ capacity in using personalised medicine tools that are increasingly sophisticated and swiftly obsolete technologically? How will this change fit in our societies models? How to avoid a behavioral overflow?
Healthcare players, politicians and public authorities must imperatively keep control over this massive arrival of innovation, by drawing lessons from the past, by implementing visionary and ambitious policies promoting access to information, training, equipment, by supporting the deployment of specialized platforms and centers of excellence and the development of best practice recommendations not only for health care givers but also for the public.
Anticipating the magnitude of upheavals and societal impacts will allow to better integrate the medical and technological revolution in our organisations and to exploit at the best the expected benefits on the quality of medical care.
EPEMED is well positioned to play an active role in the societal shift that we call personalised medicine. I invite you to join us and to participate in our efforts and I am looking forward to continue shaping Personalised Medicine with you all next year!
Alain Huriez, MD
EPEMED Founder & Chairman