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Precision medicine sounds like an inarguably good thing. It begins with the observation that individuals vary in their genetic makeup and that their diseases and responses to medications differ as a result. It then aims to find the right drug, for the right patient, at the right time, every time. The notion certainly has its supporters among medical experts. But for every one of them, there is another who thinks that efforts to achieve precision medicine are a waste of time and money. With a multimillion-dollar government-funded precision medicine initiative currently under way, debate is intensifying over whether this approach to treating disease can truly deliver on its promise to revolutionize health care.
Ask scientists who favor precision medicine for an example of what it might accomplish, and they are likely to tell you about ivacaftor, a new drug that has eased symptoms in a small and very specific subset of patients with cystic fibrosis. The disease stems from any of several defects in the protein that regulates the passage of salt molecules into and out of cells. Ivacaftor corrects for one such defect, which is responsible for roughly 5 percent of all cystic fibrosis cases. Genetic testing can reveal which individuals are eligible for this treatment.
But ask opponents for an example of why precision medicine is fatally flawed, and they, too, are likely to tell you about ivacaftor. The drug took decades to develop, costs $300,000 a year per patient, and is useless in the 95 percent of patients whose mutations are different from the ones that ivacaftor acts on.
Read full, original post: The Paradox of Precision Medicine
