Explorers have universally shared an unbridled sense of purpose for pioneering a path never before navigated and tapping into a reservoir of national and global pride that invigorates the masses. In the new frontier of precision medicine, today’s explorers do not emulate Ferdinand Magellan, Vasco da Gama, John Smith, or Neil Armstrong, wielding armor and protective gear to combat attackers or the elements. These modern day explorers exist not in solidarity as a saber rattling masthead, but instead as an harmonized team of scientists with high-performance computing clusters, politicians, patient advocacy leaders and lawyers, engineers, biopharma consortiums — and the patients themselves as part of the precision medicine cooperative.
Instead of organizing a quest thousands of miles across oceans or 230,000 miles in space, we are now tasked with measuring molecules the size of nanometers in millions of people, a far different equation than histories past. Thus, the mission and objectives of modern day explorers has dramatically evolved, since we have hundreds of technologies to utilize and laws to create, thousands of diseases to conquer, and a generation of millions of willing participants to engage who might not immediately benefit from the promises of precision medicine, since we first have to create a map of population health.
We have all heard of patients beating the odds against a devastating disease, not favoring well with conventional treatments, or not knowing what disease plagues them. However, medicine has not had the diverse tools or blueprint before them to increase their successful batting averages. Medicine has always been at the caring hands of physicians and well-trained primary care doctors. In contrast, medicine is now evolving far beyond the doctor’s office in how it will be practiced and utilized, since patients have more access to technology and information than ever before and doctors are looking for informed guidance beyond their medical training.
The outreach in educating the population about the opportunities, risks, and the ongoing efforts/technologies that are evolving to enact precision medicine has to be multi-dimensional and multi-generational to ensure that there is a harmonized understanding of the impact, timeline, and incorporation of precision medicine. In a world where we have real-time access to all information, the public must anticipate that precision medicine will start out in metrics of weeks to months, and eventually become more immediate with the strategic investments, improvements in technology, as well as exponential participation of the population.
The corresponding advancements in electronic health record infrastructure, decreased cost of innovative OMIC technologies, novel molecular diagnostics to stratify patient response, improved computing capabilities, as well as looming unsustainable pharmacoeconomic model that puts our national security at risk, has awoken a world that demands precision in our medicine. The challenge is to define the best path forward for disruptive innovation, while investing, educating and agnostically testing technologies that hold the most promise.
Precision medicine will not happen easily, it will take unrelenting commitment from patients, governments, and pharmaceutical companies. This is not a ‘moonshot’ or Manhattan project scenario since the vast majority of the population is unsure how it will impact them, until it is too late. There will be failed attempts to form a new healthcare system around precision medicine, however, it will come down to the entire population demanding effectiveness of the pharmaceutical interventions provided regardless of race, gender, age, or socioeconomic status and a fully organized effort to test and offer solutions.
Precision medicine should offer a bimodal solution to the healthcare algorithm. The first being that the technology to stratify patients should be economical in nature to prevent an increased economic burden on the healthcare system and the patient. The second part of the equation should be that this economical solution should have a dramatic increase in diagnostic precision that has been tested in the broader population. Thus, the cost benefit should be clear and the population benefit should be universal.
The establishment of a social contract between the government, pharmaceutical and diagnostic companies has to ensure that the first generation of precision medicine participants will be active in this process. The critical factor that must be conveyed is that this process will precipitously improve based on the amount of healthy and disease patients contributing to a global precision medicine initiative as well as the range of technologies included. There will be trial and error along the way, but the infrastructure to develop this has to be enormous.
The economic investment and potential as well as the return to patients is colossal, although it will take full undivided commitment and discipline to accomplish this. These efforts are not just about sharing resources to accomplish a goal, it is about defining scope, testing technologies, educating the masses, enacting project management strategies, engagement of health economic assessment of deliverables and unmet needs, as well as creating the entire architecture for data warehousing and dissemination into actionable clinical decision making potential. Red tape will have to be cut, laws will have to be put in place to protect patients, timelines firmly established and followed to deliver on the promises made as well as new drug development from pharma fully vested in the process.
With outcome based reimbursement pressures looming over the horizon, this is a perfect storm to rally the troops and enact change. We now have the tools to allow the exploration of our own biology to conquer that which has eluded us, fundamentally using the elements within us to change the face of medicine.
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Filed Under: Drug Discovery