Pharmacogenomics: Expectation vs Reality
One of most appealing parts of the rise of pharmacogenomics is how close we seem to be to removing "trial and error" from the vocabulary of medication. It promises the increased efficiency of treatment by skipping the 'kissing a lot of frogs' phase, which would theoretically decrease the average amount of useless prescriptions, doctor's visits, and patients' time spent without relief. Financially, this has huge potential to change the current state of healthcare.
However, even after only looking at the sunny side of the future of treating disease, reality doesn't seem to be reflecting the same hope we might have predicted. Myriad, a company originally made famous by its genetic testing for cancer risk decades ago, has delved into designing tests that predict the efficacy of drugs based on patients' genetics. The specific project that's made the most headway is known as GeneSight, which aims to inform care providers about interactions between genes's effects on the efficacy of antidepressants.
Courtesy: Barron's; illustration by Rose Wong
Major depression is one of the most well-known of disorders that, more often than not, doesn't improve after the first drug tried. Improving success rates in initial treatment would be remarkable in that it could change both the lives of patients and the fiscal landscape of the pharmaceutical industry. However, the development of GeneSight doesn't seem to be having much of any positive effect on Myriad as a company.
The business side makes sense after taking into consideration how truly helpful these genetic tests currently are to care providers and patients. According to a psychiatry professor involved in GeneSight's initial study, "you’d have to test about 20 treatment-resistant patients with the $2,000 product to get one additional person to remission." With those odds, pharmacogenomics as the new way to cure disease doesn't seem nearly as promising.
How do you think the case of GeneSight might impact the world of Big Pharma going forward? Is there a way for the international community to regulate or improve the ways in which private entities like Myriad use technologies like genetic testing to find personal drug efficacy?
I'd love to hear your comments!
However, even after only looking at the sunny side of the future of treating disease, reality doesn't seem to be reflecting the same hope we might have predicted. Myriad, a company originally made famous by its genetic testing for cancer risk decades ago, has delved into designing tests that predict the efficacy of drugs based on patients' genetics. The specific project that's made the most headway is known as GeneSight, which aims to inform care providers about interactions between genes's effects on the efficacy of antidepressants.
Courtesy: Barron's; illustration by Rose Wong
Major depression is one of the most well-known of disorders that, more often than not, doesn't improve after the first drug tried. Improving success rates in initial treatment would be remarkable in that it could change both the lives of patients and the fiscal landscape of the pharmaceutical industry. However, the development of GeneSight doesn't seem to be having much of any positive effect on Myriad as a company.
The business side makes sense after taking into consideration how truly helpful these genetic tests currently are to care providers and patients. According to a psychiatry professor involved in GeneSight's initial study, "you’d have to test about 20 treatment-resistant patients with the $2,000 product to get one additional person to remission." With those odds, pharmacogenomics as the new way to cure disease doesn't seem nearly as promising.
How do you think the case of GeneSight might impact the world of Big Pharma going forward? Is there a way for the international community to regulate or improve the ways in which private entities like Myriad use technologies like genetic testing to find personal drug efficacy?
I'd love to hear your comments!
Hi everyone, my name is Robert and I'm a delegate for Malaysia.
ReplyDeleteI think that such a technology would greatly improve efficiency of medicine but currently isn't a viable option for widespread use. Due to its current price and availability, I wouldn't expect anyone below middle class in even developed countries to have access to this technology. Most of its drawbacks probably arise from the fact that it's new technology with many improvements to be made. I think the global community should encourage more research into this so those improvements can be made as quickly as possible. Measures should also be taken to ensure that companies like Myriad don't become the sole researcher and business in pharmacogenomics (see, it's so new that autocorrect thinks I spelled something wrong). Once it's more developed, techniques like GeneSight may revolutionize modern medicine and the way we prescribe drugs, improving the livelihood of millions or more. Until then, however, I think the best move is to sit, wait, and let the business grow into a more manageable size.
I yield my time to the chair.
I'm sorry, I just couldn't help it. :D
Hello! Belgium agrees with Malaysia in that these technologies are currently inaccessible to the general public, due to its staggering price and unpredictable results. However, currently, the capability of governments to do research and experimentation in the field of pharmacogenomics is limited by the widespread uncertainty surrounding genomic modification and its consequences. Additionally, Belgium believes strongly in the value of private enterprise and free trade, with little government intervention. As such, we propose that private companies be allowed to research genomic modification, as long as their experiments are approved by any international or federal ethics regulations it may fall under. This will spur scientific progress, as private companies are not limited by the public in the same way that governments are. Additionally, the competition of free market will motivate other private companies to pursue pharmacogenomic research as well. This will self-regulate the market, as prices will drop to a reasonable price level. This could also further international knowledge in genomic modification and pharmacogenomics and lead to some life-changing breakthroughs. We look forward to discussing this further in committee!
ReplyDeletePeru also agrees with Malaysia in that it is difficult for developing countries to have access to the technology that brings about genomic healthcare. While Peru recognizes the benefits of genomic healthcare, there are also many repercussions that can come from it as well. Peru wants to focus a lot on how genomic healthcare experimentation can lead to unclear relations among the international community when discussing the future of genomic healthcare. There must be a declaration/agreement in place that has clear guidelines on what can be tested internationally. For example, the international community may decide that gene therapy is beneficial and ethical, but may go against human experimentation involving CRISPR-cas9.
ReplyDelete