Do advocates overestimate the benefits of personalized medicine?

The advocates of personalized or precision medicine may have set up unrealistic expectations about its promise while leaving many questions unanswered, according to a viewpoint article in the Journal of the American Medical Association.

"Even though personalized medicine will be useful to better understand rare diseases and identify novel therapeutic targets for some conditions, the promise of improved risk prediction, behavior change, lower costs, and gains in public health for common diseases seem unrealistic," wrote Michael J. Joyner, M.D., department of anesthesiology, Mayo Clinic in Rochester, Minnesota, and Nigel Paneth, M.D., department of epidemiology and biostatistics, College of Human Medicine, Michigan State University.

Proponents must answer questions about how personalized medicine will change healthcare and be more realistic about what the public can expect, the authors wrote. The most important question, according to Joynet and Paneth, is: Where is the public health benefit to personalized medicine?  If the initiative will not reduce major causes of mortality and morbidity, federal agencies, including the National Insitutes of Health, should question the reasoning behind the big investment in personalized medicine.

President Barack Obama introduced the Precision Medicine Initative in his State of the Union address earlier this year, requesting $215 million for various agencies to pursue a wide-reaching effort to use patients' genetic profiles to map out specialized treatment.

Advocates say personalized or precision medicine will radically transform medical care and public health with prevention and treatment programs more closely targeted to the individual patient, wrote Joyner and Paneth. But they argue that assumptions underpinning personalized medicine have largely escaped questioning. They are not the first to warn the president's initiative may not revitalize medicine as much as proponents advertise; other experts have cautioned that meaningful progress will be a gradual transformation rather than the "revolution" of the precision model.

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