Gianrico Farrugia, CEO of Mayo Clinic in Florida, laid out his vision of the immediate future of precision medicine at this week’s Individualizing Medicine Conference in Minnesota.
He discussed the issues around patient engagement, reimbursement, data security and salience of President Barack Obama’s Precision Medicine Initiative. In terms of immediate potential, Farrugia said there are five fields worth watching:
- Pharmacogenomics
- Liquid biopsy
- Non-invasive prenatal testing
- Whole genome sequencing
- Microbiome
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To bring these powerful technologies to work in harmony, venture capital, industry and academic medical centers need to work as each others’ checkpoints, Farrugia said.
As for reimbursement, it’s up to researchers and clinicians to really demonstrate the utility of precision medicine to insurers. Academic medical centers have a responsibility to be transparent about cost.
“We have to be careful we don’t mess up on this. That we don’t overstep our boundaries,” Farrugia said. “It’s totally on us. We show value and benefit, then they’ll pay.”
When it comes to selling consumers on the value of genomics, targeted therapies and the like – it won’t actually be that hard. President Barack Obama’s Precision Medicine Initiative, “a bold plan” according to Farrugia, has organically attracted sufficient attention to successfully enroll the one million necessary clinical trial participants.
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“We don’t need to pitch it very hard,” Farrugia said. “We’ve never had an undersubscription of trials in this space. We don’t need to sell something here.”
In terms of bioethics and privacy, it’s critical to involve patients – consumers – from the ground up. Patients today tend to be satisfied with the way clinical genomics are used – satisfied even when diagnosticians can’t pinpoint a specific diagnosis even after deep testing, Farrugia said. But patient engagement is everything in terms of pushing precision medicine to a more scalable level – as is data privacy.
“It’s still so important that patients, consumers and providers have a very loud voice in the implementation of clinical genomics,” Farrugia said. “Patients have told us really loudly, clearly, that they want to be the only people that control what gets back to them.”
Consumers are, after all, “pretty darn educated.” It’s paramount to hold honest, realistic conversations with consumers – trickling back to industry’s role here, transparency is key.
Though he gave a comprehensive overview of the present state of precision medicine, Farrugia took a starry-eyed look into its longer-term outlook:
“I hope I can’t imagine it,” he said. “If I can imagine it, it won’t be that exciting.”
