On Precision Medicine, Obama Is Playing the Long Game
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WASHINGTON — President Obama had one major challenge at his precision medicine summit on Thursday: avoid getting bogged down in jargon.
Instead he kept his eyes on the horizon, focusing on the benefits he envisions 10 years from now if precision medicine moves forward: better, more effective medical treatments tailored to individuals, and eventually lower costs because there will be less spending on treatments that don’t work.
“My hope is that this becomes the foundation, the architecture whereby 10 years from now we can look back and say we that we have revolutionized medicine in areas like cancer, or Alzheimer’s, or some of the other diseases that have caused so much pain and suffering for families all across the country,” Obama said during a panel discussion at the White House summit.
“There’s no better place to do it than in the United States of America where innovation and R&D has been the hallmark of driving not only our economy, but the improvements that we’ve seen in life expectancy and the quality of life for people around the world,” he said.
By talking about the payoffs years from now, and invoking his daughters at one point, Obama was clearly framing the precision medicine initiative and other medical research projects — including Vice President Joe Biden’s cancer “moonshot” initiative — as investments that could help shape his legacy after he leaves office next year.
“If we get this right now, and this includes the cancer moonshot that Vice President Biden is initiating … I’m confident that at least for Malia and Sasha’s generation, they’re going to be able to make progress and live healthier lives in ways that we could not imagine,” he said.
Obama acknowledged that a major barrier could be “the economics of treatment,” noting that drug companies may be less willing to invest in blockbuster treatments that treat a small number of patients.
But he also predicted that precision medicine could help the problem of overspending in the health care system, because doctors would have a better idea of what’s most likely to work on each patient.
“Over the long term, we can save a lot of money, rather than make this more expensive, if every drug we prescribe actually works,” Obama said.
“If the doctor with his kidney patient knows that this is not going to work and that’s not going to work, he’s not going to be wasting a huge amount of time, effort, surgery, etc. on a path that’s less likely to succeed. He’s going to be saving money and focusing entirely on those pathways that we know are going to work,” Obama said.
The summit wasn’t jargon-free, to be sure. There was lots of talk of “research cohorts” and “data sharing,” and Obama joined in with everyone else, noting that the big questions ahead will include “who owns the data” and how to protect the privacy of people who volunteer to share their medical data for research.
But for the most part, Obama focused on the long-term goals. He even suggested that precision medicine could, in the long run, provide new solutions to the opioid abuse epidemic that has plagued so many communities.
“We don’t yet know the genetic basis for addiction … in a way that we could discover 10 years from now, or 15 years from now,” he said.
The goal of Obama’s precision medicine initiative, which he launched last year, is speedier research into treatments tailored to individual patients. His latest budget asks Congress for $309 million for the initiative next year, an increase of more than $100 million over this year’s spending.
The initiative includes a National Institutes of Health project to gather data on the health habits of 1 million volunteers, a goal the NIH hopes to reach by the end of 2019. In addition, the National Cancer Institute is putting a new focus on studying the genomic factors that can lead to cancer.
Unlike so many other issues where Obama and congressional Republicans are at each other’s throats, the precision medicine initiative is one that has a fair amount of GOP support.
Senator Lamar Alexander, the chairman of the Senate Health, Education, Labor, and Pensions Committee, was especially pleased that the first NIH award in the project — $1.3 million to set up a pilot program to recruit medical volunteers — is going to Vanderbilt University, located in his home state of Tennessee. Vanderbilt will be working with Verily, the company that used to be called Google Life Sciences.
In a statement, Alexander called the award “a big compliment to Vanderbilt” and said he is “committed to supporting the president’s precision medicine initiative through our Senate health committee’s innovation agenda to ensure Americans can take advantage of this remarkable time in science.”