Healthcare Customization: One Size Does Not Fit All

Precision medicine. It’s a buzzword-worthy phrase that has gotten an immense amount of attention recently, but what makes it so interesting?

Precision medicine (also known as personalized medicine) revolves around harnessing large amounts of data with regard to a person’s genetic makeup, drugs and therapies can be tailored to be more effective and targeted. This shift away from the “one size fits all” approach combines genetic factors with lifestyle, nutrition, and environment in order to design customized treatment plans. This could mean either creating new treatments or modifying existing treatments based on genetic factors.

The rise and influence of artificial intelligence and machine learning in the field of healthcare is popularizing precision medicine, but the reality is that this concept has been around for a long time. Think of something as basic as a blood transfusion — you can match a transfusion with a specific blood type. This is precision medicine in one of its simplest forms.

Source: Adapted from Bayer Healthcare, “Personalized Medicine.”

Thanks to consumer DNA testing companies, like 23andMe and Ancestry, genetic testing has become slightly more mainstream. As of now, 23andMe has over five million customers, and 80% of those customers have consented to participate in research — that means that their database holds genetic information for approximately four million people. Ancestry, on the other hand, has tested over seven million people.

This means that over twelve million people in the US alone have access to their genetic data; assuming a national population of 325 million, this equates to approximately 1 out of every 25 people, which may seem small but is actually quite sizable. Both of these companies, along with other lesser known ones, allow customers to download their data, while other companies, such as Habit and Promethease, take that data and analyze it to provide people with additional information regarding their health and risk factors.

What are other ways in which this data is being used? In addition to customers having access to their data, these companies are also able to provide value to larger drug companies to develop targeted medicines. In July 2018, 23andMe announced a partnership with GlaxoSmithKline to develop personalized drugs using DNA data from the 23andMe database, starting with treatments for Parkinson’s disease.

In 2015, President Obama launched the Precision Medicine Initiative, a research effort aimed at improving how diseases are diagnosed and treated. This initiative, coupled with the completion of the Human Genome Project in 2003 has paved the way for innovation and research in this field and has expanded the market significantly.

As evidenced by the amount of money being funneled into research and the public interest in DNA testing, this is an area that has attracted a lot of VC investment as well. Some firms, like Grey Bird Ventures are completely focused on precision medicine, while others, like Aspire Universal have created their own personalized medicine investment funds. Andreessen Horowitz launched their second bio fund about a year ago to invest in the junction of biology and engineering, with focus areas in computational biology, applications of AI and ML, and DNA understanding.

In addition to receiving large investments, this field of medicine is also performing well in on the regulatory side of things. According to an analysis by the Personalized Medicine Coalition, in 2018 there was a record number of 25 personalized medicine approvals by the FDA, which accounted for 42% of all new drug approvals last year.

Clearly, it’s a growing area of medicine. However, there are drawbacks to precision medicine that should not be ignored — the biggest of these being cost. Even with insurance, drug treatments and therapies are expensive. Imagine the incremental costs of drugs that are personalized based on your genetic makeup — the costs easily will skyrocket. Privacy risks as well as misinterpretation and misuse of genetic data should not be disregarded either as potential road bumps along the way.

It comes down to three things: prevention, data, and cost.

1. Prevention: Similar to fitness wearables, one of the advantages of precision medicine is prevention. Patients now have more actionable health data than ever before and they can alter their lifestyle and habits to optimize their health, and share that data with doctors so that their treatments plans are reflective of it.
2. Data: On a daily basis, massive amounts of data are generated, whether it is from genetic sequencing or fitness wearables. This larger universe of available data means that it can be cut in numerous ways to provide insights on more targeted treatment plans.
3. Cost: The cost of genomic analysis has taken a nosedive in the last two decades. Less than 20 years ago, the cost of sequencing a genome was almost $100 million; today the cost is less than $1,000. These decreased costs lead to wider uses of genetic testing and sequencing, leading to a greater understanding of precision medicine. One thing to note here is that while the sequencing costs are relatively low, using data analytics to generate valuable insights costs much more — this cost should eventually decrease as sufficient scaling takes place. Additionally, more targeted drugs lead to better outcomes, which will save patients and hospitals billions of dollars in the long run.

The precision medicine market is gaining popularity due to the rise of personal healthcare devices and integration of smart technologies in the healthcare system. People are ready to have a better understanding of their risk factors and genetic makeup and companies are starting to utilize that data to optimize treatment plans. Give it a few more years, and maybe “precision medicine” won’t be just a buzzword anymore.