Giving personalized medicine a bad name

There’s a history in health care of taking a good concept and perverting it, undermining the original meaning. Here are a couple examples:

  • Disease management –which was initially turned into a marketing tool for pharmaceutical companies
  • Consumer directed health care –which has been used as a euphemism for shifting costs to employees and for mini-med plans

“Personalized medicine” is another good concept that’s under threat for similar reasons. To me, personalized medicine is mainly about matching the right treatment to the right patient. It has the potential to improve outcomes and safety while reducing costs. Examples of drugs and companion diagnostics already exist, especially for cancer therapy. In the future we’ll have companion diagnostics in more areas. There will be tests to help determine what drug(s) to prescribe for depression and tests to determine whether a given drug will pose a cardiac risk for a specific individual.

The danger is that personalized medicine could be lumped in with genetic profiling. People are rightly concerned about being excluded from insurance and employment (maybe even marriage) if their genetic profile shows something disturbing. In addition, people may take tests showing their predisposition to one disease or another, which may add stress without providing much useful to do about one’s fate.

There’s evidence that this blurring is already happening and people are getting worked up, according to a new study. In my view it would be best to limit the term personalized medicine to companion diagnostics, a worthwhile application that’s not especially controversial. Call the other stuff genetic testing or screening.

October 26, 2007

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