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Personalized medicine: It may be high cost, but it’s higher value

Personalized medicine will be expensive in these early days of pioneering and planning. But individual genomic testing is not going to be exorbitant forever – and the ROI is gonna be big, both in patient outcomes and dollars saved, said a panel of speakers at MedCity’s CONVERGE conference in Philadelphia. “Because pharmacogenomics is rooted in the pathobiology of disease, […]

Personalized medicine will be expensive in these early days of pioneering and planning. But individual genomic testing is not going to be exorbitant forever – and the ROI is gonna be big, both in patient outcomes and dollars saved, said a panel of speakers at MedCity’s CONVERGE conference in Philadelphia.

“Because pharmacogenomics is rooted in the pathobiology of disease, the implications of that are going to be huge moving forward,” said Hakon Hakonarson, director of the Center for Applied Genomics, The Children’s Hospital of Philadelphia. “But in the short term it’s going to be more expensive.”

To bridge the gap between today and a future where personalized medicine is the norm, companies are reaching for the low-hanging fruit: Cancer.

“The elephant in the room is that 70 percent of the cancer drugs don’t work for their intended use,” said Gerald McDougall, a principal at PriceWaterhouseCoopers Health that focuses on personalized medicine. Because of this, building companion diagnostics around cancer variants and cancer drugs is extraordinarily promising from both a clinical outcome and a revenue perspective, he said.

“As an investor, we’re seeing the bulk of companies that have made significant commercial traction in the personalized medicine space have been focused on cancer,” McDougall said.

If one examines what’s happening in capital markets in diagnostics, a sea change is underway, said Andrew Jay, an investment partner at Siemens Venture Capital. Because genome sequencing is rising in value and availability, and it’s dropping in cost — widespread adoption is inevitable, he said.

This is partly attributable to the fact that the cost of reagents and sequencing is decreasing at a rapid clip; the real expenses are starting to come from the amount of human hours it takes to put in the benchwork and analyze the results, said Manuel Glynias, president and CEO of Cleveland-based GenomOncology. But those time frames are also quickly narrowing, he said, which is allowing companies to already book revenue and forecast increases down the road.

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

However, with dropping costs, the question of quality versus cost are starting to arise — cheaper, less reliable sequencing options are already springing up, leading to a contentious question among the panelists: Do you get what you pay for in sequencing? It’ll be up to providers to weigh the options of value per dollar, Glynias said.

But the key takeaway from the discussion was summed up nicely by McDougall:

“I don’t see anything in healthcare that isn’t going to be related to personalized medicine,” he said.

 

Image of the proverbial “low-hanging fruit” courtesy of Flickr user Luis Toro.