Science alone will not lead to better medicines

What is the Personalised Medicine Coalition and how does it hope to advance personalised medicine?

Personalised Medicine Coalition (PMC) is an education and advocacy organisation publicly launched at the end of 2004 on the assumption that science alone was not going to lead to better medicines for patients. The Coalition educates decision makers about the power and potential of personalised medicine, and seeks to create a friendlier landscape for its advancement.

Edward Abrahams

What barriers are currently hindering progress in the field of personalised medicine and what can be done to overcome them?

Currently, regulatory, reimbursement and education systems are not aligned to facilitate the development and clinical adoption of personalised medicine. The markets get mixed signals, physicians are not sufficiently aware of what the new developments are, and payers are seeking evidence for diagnostic technologies that they don't understand or see the value of without more information. These issues need to be addressed, and that's what the PMC is designed to do.

In which area of personalised medicine is innovation needed the most?

The science of personalised medicine is still in early stages and we need a better understanding of how human biology works; how individuals are different and how they respond differently to different treatments. Therefore, I would say the most important area for development is a better understanding of the science of individual variation. In short, how people are different.

Hopefully, reimbursement, regulatory and education systems will send the right signals so that the right investments will be made and, in turn, we will discover the principles of individual difference. That will position physicians to better treat disease, even before it happens. We're not there yet, but we have more tools than we ever had before, in part because of the declining cost of genetic sequencing. In a short time the cost of sequencing a human genome has fallen from $3 million to less than $50000 today, and we're en route to a $1000 price tag within a couple of years. That tool alone could transform the science that underlies personalised medicine.

What advice would you give to a company considering investing in personalised medicines but is concerned about their return on investment?

To quote the hockey player Wayne Gretzky, "...you skate to where the puck's going, not to where it is." Companies will always and should always be concerned about return on investment. Stratified medicine is already changing the dynamics of medical care, and judging by the increased valuations of diagnostic companies, I would say personalised medicine is a good bet.

What are your predictions for the future of personalised medicine and its place in global healthcare regimes?

If you talk to scientists, without an exception, they all believe that we are moving away from a "one size fits all" paradigm to one that respects individual variation because there is going to be no other way to address the aetiology of complex diseases. Progress in medical research depends on how people differ. The question is, how fast is that research going to translate itself into the better, more efficacious, safer products that personalised medicine promises to deliver? Nobody has a crystal ball; one can only say that we see increased evidence of investment and increased output of products from pharmaceutical and diagnostic companies that benefit patients.

PTE Digital extracts

Pharmacogenetics

Despite the hype and hope of pharmacogenetic tests, few are presently in use. To understand why, we performed a systematic review of pharmacogenetics and found several reasons that could account for the slow advance. For example, lack of focused research, small sample sizes, reporting bias and lack of data across populations. Based on our appraisal, we have ascertained the current state of pharmacogentics research and have provided several recommendations that we hope will aid its future advancement.

Read in full at www.pharmtech.com/ptedigital0410

Michael Holmes

Aroon Hingorani

Juan Casa

University College London and London School of Hygiene and Tropical Medicine

Partnerships prosper

The most direct control mechanism to study whether a particular treatment is successful or not is to develop molecular diagnostics and imaging in close collaboration with drug and biomaterial design. In these programmes, the diagnostic component can be positioned as the personal litmus test for treatment efficacy on a personal basis. To translate research of this kind into healthcare solutions for patients, cross-fertilisation between academic, clinical and industrial research is be important. Public-private partnerships provide unique incubators where intellectual creativity and real life applications come together.

Read in full at www.pharmtech.com/ptedigital0410

Professor Frank Baaijens

Professor peter Luijten

Professor Daan Crommelin

BMM, CTMM and TI Pharma