What will 'precision medicine' mean for providers?

President Barack Obama's comments in his State of the Union speech on Tuesday evening got the healthcare world abuzz about "precision medicine"--but what exactly that will mean for the industry remains unclear.

"I want the country that eliminated polio and mapped the human genome to lead a new era of medicine--one that delivers the right treatment at the right time," Obama said.

To usher in this "new era of medicine," Obama called for a national Precision Medicine Initiative "to bring us closer to curing diseases like cancer and diabetes--and to give all of us access to the personalized information we need to keep ourselves and our families healthier."

That personalized information comes from the relatively new field of mapping patients' genes to determine their risk factors for certain diseases, according to the National Journal. While the field of applying genomics to medicine is promising, "the business of translating that knowledge into more targeted treatments is still just getting started," the article notes.

Indeed, though such measures "aren't really relevant clinically" yet in hospitals, Obama's backing of precision medicine may improve patient care in the future, Jeremy Tucker, regional medical director of MEP Health in Germantown, Maryland, and a member of FierceHealthcare's editorial board, told FierceHealthcare in an exclusive interview.

"That was probably one of the positive or high points in [Obama's] speech from a medical perspective," Tucker said, pictured right, adding that it "likely has the promise to reduce healthcare costs, and at the same time save lives."

For example, Tucker said, right now providers treat all Type II diabetes patients the same, but in the future, they could use patterns identified by personalized genomics to map out individually tailored treatment plans for not only diabetes but coronary artery disease and strokes.

"From day one we could have better control of their disease," he said.

Tucker's views are shared by American Nurses Association (ANA) President Pamela Cipriano, who praised the president's speech in a statement Wednesday.

"The president's address showed a keen understanding that improving health for all has benefits which extend far beyond just feeling better; better health allows people to have peace of mind and achieve our full potential as contributors to society," she said. "For example, the Precision Medicine Initiative President Obama described during his speech has the potential to generate more effective treatments for serious diseases."

Even before Obama's speech the National Institutes of Health identified precision medicine as No. 2 in its top four priorities in its fiscal year 2015 budget proposal

"NIH seeks to understand human variability and identify individuals who differ in the susceptibility to a particular disease, in the trajectory of those diseases if they develop, or in response to a specific treatment," the proposal states. "In this way, specific preventive or therapeutic interventions can be tailored--avoiding needless treatment and expense for those who will not benefit."

As with nearly all politically backed initiatives, however, the issue of funding will ultimately determine the potential--and limits--of precision medicine.

While Obama told the nation that "in some patients with cystic fibrosis, [precision medicine] has reversed a disease once thought unstoppable," one such drug, Kalydeco, is priced at about $300,000 per patient per year, wrote Forbes contributor David Kroll.

"As medicine becomes more precise in classifying diseases into their discrete, genetic subtypes, the patient populations benefitting from a given drug are reduced," he wrote. "The result is that we are developing more effective drugs with dramatically greater effectiveness, but for a market of a few thousand or even hundreds of patients."

While Tucker acknowledged that "the money has to come from somewhere," to fund cutting-edge medicine like genomics, "the cost savings down the line should be significant," he said.

Perhaps what the precision medicine movement needs most to flourish is less government intervention, William Cors, vice president/chief medical officer of the Pocono Health System in Pennsylvania and a member of FierceHealthcare's advisory board, wrote in an email to FierceHealthcare.

"For such innovation to occur, the government needs to back off some on the regulatory side, as too many regulations stifle and crush innovation," he wrote. "It holds great promise if we can just get out of the way and let it happen."

To learn more:
- access the budget proposal
- read the National Journal article
- check out the Forbes piece
- see the ANA statement

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