We’ve all heard the saying “treat the patient, not the disease”, and this couldn’t be truer in today’s ever-changing pharmaceutical landscape. We are living in a time of revolution – advancements in genomics and technology are improving our ability to develop precise drugs and targeted therapies, rather than focusing on a one size fits all approach.
Each individual’s genetic makeup is slightly different from everyone else’s, so why are we all receiving the same medicine? To put it simply – the lucrative blockbuster business model, which has previously been the key to pharma success, is no longer viable. In a global and fast-moving world, in order to evolve, it’s time to examine new alternatives to the classic structure.
So, what is personalized medicine?
Each body is unique and our health is determined, not only by our environment and lifestyle but also by our genetic differences. We inherit variations in our genes, and even tiny variations can affect how we respond to certain medications.
Most healthcare workers will know that the same drug doesn’t always work in the same way for each patient – for instance, an anti-cancer drug may shrink a tumor in one person, but cause another to suffer severe side-effects. This idea lies at the forefront of personalized therapies – essentially that each patient has a unique biology, and that this should be reflected in treatments.
While blockbuster drugs are seen as a one size fits all approach – developed to treat large patient populations – personalized medicines focus on smaller subpopulations with distinct genetic variations and profiles. Researchers are currently investigating and identifying these genetic variations, which are then matched with specific medications and the response documented to help develop a more personalized approach.
Why do we need precision medication?
The practice of medicine has always been mostly reactive – you get sick, make an appointment with your doctor, and are prescribed medication that works for most adults with the same illness. But what if that treatment doesn’t work? That’s where precision medicine comes in.
Today medicine choices often work on a trial and error basis, which can not only result in terrible side effects or even irreversible conditions but are also costly and time-consuming. Pharmacogenomics offers a unique way to combat this. For instance, a person diagnosed with diabetes can be offered a blood test to identify any genetic variations that may affect how they will respond to certain medications. This allows doctors to skip specific drugs, instead choosing one that best fits with a patient’s genetic profile. By personalizing treatments based on your unique genetic makeup, doctors are able to not only predict your susceptibility to certain diseases, preempting progression, but also to prescribe more effective drugs from the offset. By shifting this emphasis from reaction to prevention, doctors can eliminate trial-and-error prescriptions, reducing time and costs associated with ineffective and imprecise medicines.
How are they developed?
With precision medication, it all comes down to genes – namely looking at a patient's individual genetic makeup to determine if there are particular medications that will work for them. Our growing understanding of genetics and genomics, and their effect on health and drug responses, means doctors are now able to provide accurate diagnoses and more effective treatments.
Until now, we haven’t been able to predict which drug will be effective for particular patients, but new research into pharmacogenetics (how an individual’s genetic variations affect their response to different drug therapies) and pharmacogenomics (the study of how genetic variations affect drug development) can help to identify how genetic variations affect medication responses.
For example, those with a genetic predisposition for breast cancer may be tested for the BRCA1 or BRCA2 gene. If your genes show that you’re more likely to get certain types of cancer, your doctor will have an indication of treatments that you’re more likely to respond to. But, it’s not just our genetics that can determine our response to certain medicines. While it is the strongest indicator as to how you’ll process medications, factors such as your family history, the environment in which you live and your diet and exercise habits can all influence this response, too.
What are some of the challenges facing precision medicine?
While precision medicines have a huge impact on patients, there are many challenges that pharmaceutical companies need to overcome. For example, drugs that are developed to target an individual’s specific genetic characteristics are likely to be expensive, while the issue of confidentially storing patients’ health information needs to be addressed before precision medication becomes the norm.
Because this landscape is constantly evolving, with new technologies being developed every day, pharmaceutical companies need to stay on top of trends and innovations. However, R&D of precision medicines is currently more expensive than traditional therapies due to the intricacies of genetic testing. The industry is working to adapt, but utilizing the right tools and teams to focus research is key, and pharma companies need to be more proactive with innovation in order to advance their knowledge.
Changing business models in pharma manufacturing
While healthcare is the largest sector in the world, innovation remains relatively low in comparison to other industries, and so pharma companies need to adapt their business models in order to remain profitable. Essentially, companies need to be more reactive when it comes to the changing healthcare landscape.
Where traditionally pharma’s business model was based on extensively, and singularly, promoting promising new drugs, the industry has now recognized the need for a more collaborative approach to better meet market needs. It’s no longer enough to “profit alone”. By partnering up with a range of organizations – from academic institutions to nutritionists, hospitals to tech companies – organizations are able to gain a much broader picture of the outcomes of their drugs, allowing them to better market their offerings.
Barrie Dowsett, Chief Executive Officer, Myriad Associates.