Personalised medicine: technological advancements enabling greater care precision and lowering healthcare costs

I know my own body! A phrase I have said in the past and that others in medical research have voiced (1). This may stem from an intuitive knowledge that one size does not fit all and that there are slight deviations in how human bodies work.

Personalised medicine gives credence to this experience and is an increasingly popular approach to healthcare. This may sound odd as you would expect there to be an element of personalisation for each patient as a matter of course however personalised medicine also termed precision or stratified medicine (1) goes beyond what healthcare professionals have been doing for years using patients’ individual characteristics such as medical history and disease progression factors such as the size or location of tumours in a cancer diagnosis (2).  

Personalised medicine aims to provide patients further tailored care based on subtle variations between people at the level of molecular, physiological, environmental exposure and behavioural profiles (3).

This approach is applicable to prevention, diagnosis and treatment and has arisen from the great rise in information and technology available to us and our ability to analyse it with genomic sequencing, bioinformatics, big data and machine learning, digital health and wearable technology, remote health care delivery, 3D printing and personalized medical devices (4).  

Personalised medicine has great potential for increased economic benefits due to reduced wastage of resources on ineffective treatments and patient benefits as unnecessary side effects and poorly targeted treatments enhance patient experience. I can imagine that the healthcare professional may also experience an enhanced experience as due to better outcomes.

A story of impact

A research case study published in the New England Journal of Medicine (5) shows a real story of how personalised medicine produced a more effective treatment for a 21- month year old girl with auto-immune hepatitis who was unresponsive to standard treatment. Next generation sequencing allowed the discovery of an anomaly in how her immune system works which is likely to have triggered this condition. Due to this insight a specific treatment was use which produced a positive response. This illustrates a personal and societal benefit to personalised medicine being the primary approach as the first line of treatment would not have been wasted with a precision-based medicine approach and there may have been quicker recovery and less medical interventions for this young child.

Artificial intelligence and personalised medicine

Artificial intelligence (AI) has been a buzzword in the last couple of years and has even been called the fourth revolution (5) with effects as transformative as those of the industrial revolution (6) and this technological advancement inevitably has a role in personalising care in planning therapy using clinical, genomic or social and behavioural determinants of health and risk prediction and diagnosis (7)). Earlier advancements in genome sequencing made precision medicine possible however AI would allow it to work at scale allowing for interpretation of an immense level of data.

Public Health and personalised medicine

Public health operates at a population level which seems a stark contrast to precision or personalised medicine however for precision level medicine there is a need for data sourcing initiatives on a population level. This concept has given rise to a new term of precision public health defined as, “the right intervention to the right population at the right time” (8). Another view of public health and precision medicine is the  understanding that social determinants are pivotal to public health and that if the issues underpinning these determinants aren’t dealt with then precision medicine will not greatly affect major public health problems (9) and may exclude select groups of the population (10).

Technological advancements have paved the way for personalised medicine which is allowing more precise and efficient diagnosis, prevention and treatment in healthcare. Personalise medicine relies on population wide data yet provides very individualised healthcare solutions which can reduce costs of healthcare and improve outcomes and experiences for patients and healthcare professionals. Despite the excitement surrounding this approach to healthcare and the increase in funding for personalised medicine there are still underlying social determinants of health that require attention to allow for the widespread benefits of personalised medicine.

 

CABI’s Global Health Database

CABI’s Global Health Database is an excellent place to further explore personalised medicine particularly within a public health context.

References

1. Dr Mairéad O’Driscoll, CEO of the HRB, opens the HRB National Conference 2022 [Internet]. Health Research Board; 2022. Available from: https://www.youtube.com/watch?v=ThhdPoCYCQM

2. Wolpe PR. Personalized Medicine and Its Ethical Challenges. World Med Health Policy. 2009 Nov 1;1(1):47–55.

3. Goetz LH, Schork NJ. Personalized medicine: motivation, challenges, and progress. Fertil Steril. 2018 Jun;109(6):952–63.

4. Englezos K, Wang L, Tan ECK, Kang L. 3D printing for personalised medicines: implications for policy and practice. Int J Pharm. 2023 Mar 25;635:122785.

5. Chao W. The Fourth Revolution. The UNESCO Courier. 2018 Jun 25;

6. Devlin H. AI ‘could be as transformative as Industrial Revolution’. The Guardian [Internet]. 2023 May 3; Available from: https://www.theguardian.com/technology/2023/may/03/ai-could-be-as-transformative-as-industrial-revolution-patrick-vallance

7. Johnson KB, Wei WQ, Weeraratne D, Frisse ME, Misulis K, Rhee K, et al. Precision Medicine, AI, and the Future of Personalized Health Care. Clin Transl Sci. 2021 Jan 1;14(1):86–93.

8. Naumova EN. Precision public health: is it all about the data? J Public Health Policy. 2022 Dec;43(4):481–6.

9. Khoury MJ, Iademarco MF, Riley WT. Precision Public Health for the Era of Precision Medicine. Am J Prev Med. 2016 Mar;50(3):398–401.

10. Jensen LG, Svendsen MN. Personalised medicine in the Danish welfare state: political visions for the public good. Crit Public Health. 2022 Oct 20;32(5):713–24.