It’s Time to Jumpstart a Revolution in Precision Medicine

For Catherine, it was a tale of two possibilities. In 2014 came the joyful news that she was expecting twins. But then, during her pregnancy, a routine test showed she had advanced-stage lung cancer. Catherine was young and strong, but suddenly her life hung in the balance. Every day she carried her twins, runaway cells from her lungs threatened to colonize her other organs.

Catherine’s story could have ended swiftly with the loss of her life and that of her twins. But it didn’t, thanks to the emerging science of precision medicine, the wide-ranging approach that tailors treatment to an individual’s specific genetic landscape.

Precision medicine applies our expanding knowledge of genomic, proteomic and other molecular factors to the science of determining a person’s health and predisposition to disease. Rapid gains in precision medicine in recent years now offer physicians and patients an array of tools to uncover, analyze, fight, and defeat disease. Rather than rely on “one-size-fits-all” approaches driven by symptoms, doctors can target their therapies to a patient’s unique profile.

In Catherine’s case, her treatments included a precision medicine that recognized a specific genetic mutation, then selectively targeted and destroyed mutated cells, leaving the healthy ones alone.

While often associated with cancer treatment, precision medicine has the potential to diagnose and treat a range of diseases, both commonplace and rare. Precision approaches can also make obsolete the familiar “try this, try that” approach, which frustrates patients’ hopes, delays effective care, and drives up costs.

The development of breakthrough precision medicine strategies is currently in hyperdrive, spurred by advances in big data and our understanding of the human genome. But the adoption of precision medicine into our healthcare system has been slow and haphazard.

The timing for change is now. This country is already approaching a tipping point in healthcare delivery. Our current system is siloed, undermined by irrational incentives, dragged down by inertia, bloated by duplication and cost shifting, and burdened by health disparities. Yet it lumbers on.

Precision medicine can be the catalyst for change. Now is the time for an integrated, national investment in precision strategies that will deliver less expensive, more convenient healthcare to all Americans.

Consider the current state of chronic, widespread diseases such as cancer, heart disease, diabetes, COPD, and depression. In the U.S., they already account for $2 trillion each year in direct healthcare costs. Precision medicine’s impact on disability and death rates for these diseases will translate into trillions of dollars in added value, not in the far-off future but during our lifetime.

Precision approaches will also open the floodgates for many more treatments for the 30 million Americans who suffer from one or more of the 7,000 identified rare diseases.

Just as the answer to polio wasn’t cheaper iron lungs, so the answer to America’s healthcare future isn’t in doubling down on yesterday’s approaches.

It’s time to think big. As our nation gets ready to invest in infrastructure, let’s include the structural framework for the switch to precision medicine. Data is the lifeblood of precision approaches, which is why America’s infrastructure strategy should include funding for data gathering and analysis, secure data sharing, and robust individual control over personal data.

The shift to precision medicine will be an investment whose financial returns and human benefits far outweigh the initial outlay. Among the payoffs will be a deeper understanding of disease mechanisms, greater ability to predict treatment responses, speedier, higher-quality clinical trials, fewer toxic effects from new drugs, and the emergence of new types of therapies from gene-based specialty medicines.

In addition to health benefits, it’s an investment that will create millions of new jobs in science, data analysis, and healthcare.

This brings us back to Catherine. She was fortunate to receive a sequence of precision treatments that kept her cancer at bay for five more years, until they failed, and she passed away. But without that care, it’s unlikely she would have been able to deliver healthy twins, much less live long enough to see their early childhood years.

Catherine was gone too soon. We don’t have to be. Extraordinary developments are taking place in precision medicine, which holds the promise of extending lifelines for us, our children, and future generations.

Jennifer Levin Carter, MD, MPH, MBA, serves as Managing Director at Sandbox Industries, and as a strategic advisor to emerging Healthcare, Diagnostic and life sciences firms. She has founded and led two such ventures, N-of-One® and TrialzOWN.