Precision Medicine

  • Paul
  • August 6, 2020

Precision medicine offers us the potential to address the typical lack of efficacy of one size fits all treatments that only help a small portion of the population. Treatment and diagnosis are catered to the individual and based on health records and genetic code.

In the past few years, precision medicine has become a hot topic. What has changed in the last 5 years to facilitate this?

Precision medicine offers us the prospect to address the typical lack of efficacy of ‘one size fits all’ treatments that only help a small portion of the population, dependent on the disease type, embracing the terms ‘targeted therapies’ and ‘personalized medicine’. The unmet need potentially addressed is highly significant – for example untargeted cancer therapies are only effective in a quarter of patients, a third of Alzheimer’s, and around half with diabetes. Much has already been achieved with targeted therapies in oncology, focusing treatment on cancer cells with fewer side effects, as with personalized medicine.
Key enablers on the journey have included the several orders of magnitude of cost reduction in gene sequencing since the early 2000s, advances in molecular diagnostics and advanced imaging, innovations in discovery and development techniques, extensive collaboration around data mining and development of research tools and platforms. Also, precision medicine in oncology has attracted a relatively large proportion of overall R&D investment because despite smaller market segments for targeted or personalized therapies, high prices can be justified due to improved outcomes, with faster time to market at lower costs than other diseases.

What are the biggest issues you think Life Science will face rolling out precision medicine solutions (in the next 5 years)?

Precision medicine as characterized today has, however, crippling limitations. Most diseases are not caused by gene mutations, but rather involve complex genetic, lifestyle and environmental factors. Arguably, the biggest killer today is food and lifestyle related. By 2050, 70% of the 10 billion people worldwide will be living in urban environments meaning a high prevalence of sedentary lifestyles. Today already over 2 billion people are overweight or obese and yet in parallel, 2 billion are deficient in key nutrients in their diet. Right now, global health services are estimated to spend around USD $ 5.5 trillion annually due to poor nutrition. Related diseases such as diabetes, which also compromise the immune system of the elderly, are growing fast. Infection is also a neglected area, yet we could see increasing problems due to pathogens developing resistance to current treatments. How then in the future can a reframing of precision medicine help address some of these challenges?
Key to making sense of the complexity involved with most diseases and offering precision medicine therapies will be big data analyses and multiplex biomarkers. This would link new sources of information, allow less invasive testing at lower costs, encourage higher compliance, and identify disease and risks at an earlier stage to allow and promote not only earlier treatment, but also critical behavioral changes. Such new data can contribute to the evidence-based impact of precision therapies, spurring greater advances in treatments. These new multiplex sources of data include advanced imaging, ‘omics, digital biosensors, and mobile fitness and wellness to capture physiological and behavioral data at a large scale.

In 2016 there were 28M wearable healthcare devices on the market, generating new patient data, and set to be 190M by 2022. Paul, expert in Life Sciences

How will precision medicine solutions revolutionize the Life Science ecosystem?

The potential opportunity is for precision medicine to address a wider range of diseases and to help the healthcare ecosystem leverage new sources of increasingly detailed information to improve outcomes via digital personalization, precise testing and early stage indicators, enabled by AI assisted data analysis.
In the future, we could see more personalized digital communications and tools to guide and motivate improved behavior, more precise tests, diagnosis of disease subtypes and stages, and an increased range of personalized and targeted interventions to treat more precisely with fewer side effects and greater compliance. The delivery of this type of intervention becomes more of a collaborative effort across the healthcare ecosystem, involving new players and starting earlier in the disease cycle.
Drug companies will engage selectively in aspects of healthcare involved in this projected type of precision medicine, positioning to optimize value capture, while fostering increasing and new types of collaboration across the healthcare system to assure improved patient outcomes from therapies offered. Infomediary, IT, diagnostic and imaging players including big tech players like Microsoft, Google and Apple plus a myriad of digital healthcare services players will play new roles in the healthcare ecosystem, leveraging and linking data sources, providing services and developing tools to forward precision medicine solutions. In 2016 there were 28M wearable healthcare devices on the market, generating new patient data, and set to be 190M by 2022. Healthcare professionals will also need new training to harness AI based advice and tools. We may also see automated / robotic testing playing an increased role at point of care.

What advice would you give Life Science companies keen to advance in precision medicine solutions?

The rules for commercial success and options to play will continue to evolve as precision medicine advances across the healthcare ecosystem and disease areas. Precision medicine as envisaged will involve a range of data and diagnostic technologies involving advanced imaging, patient generated data, multiple healthcare players and data sources plus AI tools to analyze complex data sets at earlier stages than treated today in pursuit of better outcomes. New capabilities and collaboration will be important to effectively influence stakeholders and regulators to allow new approaches, e.g. acceptance of patient generated health data in clinical trials and of digital tools to support clinical applications. Collaboration will play an even more important role in discovery, development, launch and life cycle management, where Life Science companies will need close alliances in existing and new areas for success.