Thursday, July 29, 2010

Personalized Medicine

We are at the beginning of Personalized Medicine.  This concept can take many forms.  It can mean an evaluation the DNA of a breast cancer that predicts a poor prognosis.  (Overexpression of the human epidermal growth factor receptor type 2, HER2)  It can also mean a diagnostic test to determine if a patient will response to a specific type of cancer treatment like Gleevec (imatinib).  Recently, several companies have started offering over the counter DNA tests.  These are presently being evaluated by the FDA because of concerns for consistently and how they will be interpreted. 

On the horizon are also various autologous (your own) engineering treatments such as stem cells from your bone marrow or fat to treat heart disease.  Platelet rich plasma is another form of personalized medicine that has evolved rapidly in orthopedics and sports medicine.

An important question is who will pay for the continued development of these diagnostic tools and treatments?  The present macro health care environment is all about covering more patients with less money.  The micro enviroment (patients coming into the office) are demanding access to these new tests and treatments without regard to cost.  We will have to solve this fundamental conflict sooner than later.  It is not possible to have both.



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