Monday, October 22, 2007

Indvidualized Medicine?

An article in the October issue of the Harvard Business Review identifies the challenges of the existing use of pharmaceuticals.

Most US physicians practice "trial and error" medicine, prescribing drugs based on the results of a studied population and not patient focused probabilities of effectiveness. As a result patients are given millions of dollars worth of pharmaceuticals that will have no benefit on their health or outcomes. One conclusion is the industry needs to develop real diagnostic capability to test an individual to determine the best course of treatment. Once the characteristics of the patient are determined a personalized treatment regimen can be developed. Additionally it could drastically change the pipeline of drugs in development. Drugs that would not make it out of testing because they only have a positive effect on a small number of people could be viable if those people could be identified before they are given the drug. With proper diagnostics those drugs would only be given to the people they benefit. This could provide more stability to a pharma company's portfolio of drugs as it provides an alternative to the blockbuster strategy.

This disruptive change could have incredible effects on pharma. It would also provide a whole new function and revenue stream for the provider that can get the delivery and integration right. Is it integrated into primary care, or would hospitals make the investment to becoming leading pharmaceutical diagnostic centers? Large health systems could integrate this into a personalized medicine service line. Another clear winner could be retail clinics. They could provide diagnosis, advanced diagnostics, prescriptions and delivery in one location.

The Commonwealth Fund