Tailor-made treatments – the future of medicine

It’s fair to say that there is still a great deal of trial and error in the prescribing of modern medicine, but rapid advances in personalised medicine mean that side effects and ineffective treatments could be drastically reduced.

Even if a drug is effective against a certain condition in the majority of the population, there will still be some people that react differently to it with potential side effects. Many factors can influence a person’s response to a drug including genetics, environment, lifestyle and any other medication they are taking. However, with the ability to profile a patient’s genetic variation, doctors can guide the selection of drugs or treatment to minimise harmful side effects or ensure a more successful outcome. This approach can also indicate a patient’s susceptibility to certain diseases before they become manifest, allowing for preventative measures.

Professor John Darling, Director of Research and Dean of the School of Applied Sciences at the University of Wolverhampton, explains: "Through screening, it is possible to discover a person’s genetic sequence and understand how they might respond to a particular drug. We’re not very far away from it being possible to conduct this kind of screening on quite a large scale and there are already companies operating in this field who are focused on developing efficient methods to bring this type of screening to a mass market. This could prove highly effective in the approach to treating many chronic diseases more effectively."

A report from the Personalized Medicine Coalition: The Case for Personalized Medicine* puts the advent of personalised medicine in context: "Since the mapping of the human genome in 2003, the pace of discovery, product development, and clinical adoption of what we know as personalized medicine has accelerated."

For the pharmaceutical industry the advances in personalised medicines are something of a revolution. With arguably the most significant investment in bringing products to market than any other industry – it’s estimated that it takes 15 years and $1 billion in development, testing and licensing to bring a drug to market – personalised medicine brings with it significant opportunities to bring much greater efficiencies to the highly costly area of clinical trials.

According to Professor Darling, the investment involved in terms of time and money to bring a drug to market could be halved by making this type of screening central to the process.

The pharmaceutical industry

A key area where this technology opens up new opportunities is in the treatment of orphan diseases. By definition, these are rarer conditions that are not the focus for pharmaceutical giants as there is little market opportunity. However, with the knowledge that is gained through screening, it will be possible to take a more sophisticated approach to the clinical trial process, reducing the time and investment in bringing a drug to market. This is never going to be a mass market area, so it’s most likely that it is a niche that will develop for small and medium-sized pharmaceutical businesses.

Reducing NHS wastage

As well as the pharmaceutical industry, there is a significant opportunity to bring cost savings and increase positive outcomes for patients in the NHS. The current reliance on ‘trial and error’ creates a lot of wastage in the system, with many patients returning to doctors several times before finding the treatment that is right for them. However, a personalised approach to medicine would reduce the margin for error, with each patient being prescribed a drug that is truly effective from the start.

Darling concludes: "This degree of personalised medicine may seem a long way off, but the benefits are already being seen in practice. Genetic screening is set to be a major area of investment for the health sector over the next decade, with the potential to bring benefits to the entire population."

* May 2009, Personalized Medicine Coalition