Hope, hype, and $$$ in precision medicine

In the early days of personalized genomic medicine, skeptics wondered how tailored medical care could be profitable. Who would develop a drug for just one or a few people?

Turns out they were looking in the wrong direction. The answer lies in genetic testing more than drug development. A detailed report in today’s New York Times examines how the promise of personalized or precision medicine is being “tainted” by hype. “Across the industry,” they write,

investors are pumping tens of millions of dollars into clinical laboratories that are developing and selling the genetic tests. President Obama recentlycalled on Congress to spend $215 million next year on personalized medicine, calling it “one of the greatest opportunities for new medical breakthroughs that we have ever seen.” A major use of the federal funds would be to create a research group of a million volunteers that would provide scientists with an enormous collection of data.

Doctors and their patients, finding it hard to resist the promise, are being swept up in the excitement. The number of tests has almost doubled in the last few years, creating a $6 billion industry.

While acknowledging that some genetic tests are proving highly valuable–particularly in diagnosing different forms of cancer, which can respond highly specifically to certain drugs depending on the mutation–they note that many genetic tests are doing more to fatten corporate wallets than they are to improve patient care. The tests often run to $1000 or more.

WIth so much at stake, federal regulators are growing concerned about fraud. Turns out some doctors are ordering and charging for tests that people don’t need!

An internal chart reviewed by The New York Times suggests the company was not shy about pointing out that doctors could amass a substantial income by participating. If a doctor enrolled five patients per day and took 110 swabs per month, that physician could earn as much as $125,400 in compensation from the study over a year.

Shock and awe!

2 thoughts on “Hope, hype, and $$$ in precision medicine”

  1. The Times article is very nice. I wish, however, that we were genetically literate enough to be dissatisfied with the journalists failure to describe Renaissance RX as a purveyor of a small slice of the many pharmacogenomics tests that are available. Instead, they just say “genetic tests.” I don’t think they trust their audience, and maybe that is well founded. However, if you were going to describe the Edsel automobile as a classic example of a poorly designed automobile, would you be taken to task for overgeneralizing when you concluded that all cars suck?

    • Thanks for your comment, but it’s made clear in numerous places that Renaissance does not stand for the entire industry. Nor does the article conclude that all pharmacogenomics sucks. For example, they say that “Critics of the rapid rise in testing say Renaissance represents some of the perils of the industry.”

      Yes, it presents a critical picture, but I posted it because I believe some criticism is a necessary corrective to the enormous amount of totally uncritical hype that’s out there. This is just the way investigative reporting works. When they’ve got 20 examples they’ll have themselves a book.

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