THE 4PS OF PERSONALIZED HEALTH CARE
- Predictive: Identification of individual risks of developing certain diseases based on the person’s genetic profile and other personal information
- Preventive: Methods and treatments to avoid, reduce and monitor the risk of developing certain diseases
- Personalized: Clinical interventions based on the unique genetic, medical and environmental characteristics of each patient-citizen, and genomic profile of his/her diseases
- Participatory: Citizens are fully engaged in personal health management
Molecular Biology: Cracking the Code of Human Life
Research in molecular biology are constantly pushing back the frontiers of knowledge on the human body – how it functions, breaks down and interacts with its environment. Ten short years ago – in 2003 – it took 13 years and $2.7 billion to complete the Human Genome Project. As technology progresses, it will soon be possible to sequence a person’s whole genome in 24 hours for $1,000 or less.
The field of genomics deals not only with the genetic characteristics and abnormalities of patients but also with the genomic profiles of their diseases. Researchers are working on identifying the genes, proteins and other biomarkers of tumours, infections, dysfonctions and disease predispositions of the human body. With this information, we will be able to better identify, prevent, and treat various health problems.
Companion Decision Tools to Guide Treatment
At the moment, the effectiveness of treatments for any disease ranges from 30 to 50 percent. This low rate of effectiveness is due to the fact that most drugs are developed for the population at large, even though individual patients respond differently to a given treatment. While human beings may share a genetic code that is 99.9 percent identical in all individuals, that 0.1 percent difference, associated with the various genomic attributes of diseases, significantly influences how a person responds to a treatment.
One example is the KRAS test for metastatic colon cancer. Studies have shown that 40 percent of patients with metastatic colon cancer are unlikely to respond to the drugs called Vectibix® (panitumumab) and Erbitux® (cetuximab) because their tumors have a mutated form of the KRAS gene. Current guidelines recommend that only patients with the normal (not mutated) form of the gene be treated with these drugs along with chemotherapy.
ICTs: Capturing and Interpreting Health Information
The new information and communication technologies are making it possible to access a large volume of data to be used in healthcare management. One example is the centralized patient health record, which will one day link together a person’s lifelong medical and pharmaceutical history. This wealth of information will help guide physicians toward more effective clinical interventions and treatments that take into account a patient’s full medical history. More rigorous monitoring of vital signs will also be made possible with remote devices worn by patients and connected by Internet and mobile network.
In addition, aggregating major health databases will pave the way to an enhanced understanding of health indicators and the evolution of public health. As a result, public health policies will be more efficient and better targeted.
Clear Clinical Benefits
On the clinical front, personalized health care approaches will enable us to:
- Identify individual risks of developing certain diseases and adopt prevention measures to avoid their onset;
- Screen and diagnose diseases sooner and less invasively, for the timely management of patients and better health outcomes;
- Determine which drugs and treatments will be more effective and cause the fewest adverse effects based on the specific traits of patients and their diseases;
- Monitor more closely the evolution of certain diseases, leading to the right intervention at the right time.
Over 70 personalized health care drugs, treatments and diagnostic tests are already on the market today. Many others are at the development, clinical assessment or validation phase.
Personalized health care is an integral part of a dynamic new trend that takes into account a person’s environment, lifestyle, diet, values and lifelong medical data. With this approach, citizens themselves are called upon to play a more active role. They will no longer be passive recipients of medical services, but empowered actors in the management of their personal health. In the new paradigm, the patient will become a citizen.
Major Social and Economic Advantages
Personalized health care is especially well suited to meet the health challenges of the 21st century. This is particularly true in the case of chronic diseases and aging, which account for the highest morbidity and mortality rates and the greatest share of healthcare resources in developed countries. Personalized health care is our opportunity to diminish the spiraling costs of healthcare services by making the most of available budgets while improving the health of citizens and populations.