Dr. Laura Esserman (right), director of UCSF Carol Franc Buck Breast Care Center, speaks May 22 at the Health Technology Forum.
Personalized medicine isn’t quite ready for primetime, according to speakers at the 5th annual Health Technology Forum Innovation Conference on the campus of Stanford University.
“There’s no such thing as personalized medicine in action,” said Dr. Laura Esserman, director of the University of California, San Francisco’s Carol Franc Buck Breast Care Center. In other words, Esserman explained, there has been an “incredible absence in clinical performance” of genomic medicine.
Sean Sigmon, healthcare business development director at software company Oracle, agreed, saying that personalized medicine has been shown to work in a laboratory environment, but still has to find its way into the clinic. “I think the greatest opportunity in personalizing medicine is making it real,” Sigmon said.
The path to that goal is in aggregating data from multiple sources, and then processing that data to make it relevant. “One of the things I focus on is making the data actionable for both the patients and the physicians,” said Harveen Sethi, director of user experience at prenatal test-maker Natera.
Setha said that healthcare innovators should focus on creating personalized diagnostics first, then get into personalized treatments, because personalized medicine is so broad.
Moderator Dr. Mike Hogarth, vice chair of pathology at UC-Davis Health System, faulted large health IT vendors for making it so difficult to extract data from electronic health records. “How do you deal with that wall?” he wondered.
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.
Other panelists agreed, but said there are some other factors at play as well. Not the least is Esserman’s perception that clinicians may have too much anxiety over what is certain rather than what is probable. “We have to get out of this incredibly risk-averse strategy” in applying genetic testing, Esserman said.
“The FDA is buried under a mountain of data, 90 percent of which is irrelevant,” Esserman added. “We need to focus on what is mission-critical to us” in terms of applying new medical knowledge to clinical practice.
Another issue is lack of transparency in healthcare, which makes it difficult to know if a single, expensive genetic test is more worthwhile for a specific patient because it gives more certainty than multiple regular screenings for conditions such as cancer.
“I actually think we need to spark innovation around value, but the reason why we can’t is because we don’t know about cost,” Esserman said. She lamented that medical students aren’t learning what things cost.
“I think we need a revolution about value,” Esserman added.
