Personalizing health care: feasibility and future implications

BMC Medicine

Lars L Gustafsson^2,20  Raghib Ali^4,42  Corrine Zara^3,30  Durhane Wong-Rieger^2,21  Menno van Woerkom^1,18  Magdalena Wladysiuk^1,13  Luka Voncina⁵  Vera Vlahovic-Palcevski⁹  Dominik Tomek^2,25  Steven Simoens^3,39  Catherine Sermet^3,33  Gisbert Selke^4,41  Ulrich Schwabe^1,10  Ken Paterson⁷  Fredrik Nilsson^2,26  Laura McCullagh^2,23  Andrew Martin³  Kamila Malinowska^1,11  Sven-Ake Lööv^2,27  Ott Laius^1,17  Christina Kvalheim¹  Marija Kalaba^3,37  Saira Jan^3,35  Krystyna Hviding¹  Harald Herholz^2,28  Alan Haycox^3,36  Katharine Harris^1,15  Miguel Gomes^2,22  Kristina Garuoliene^4,40  Jurij Fürst^2,24  Alessandra Ferrario^1,12  Eduardo Diogene^1,14  Stephen Campbell^3,34  Anna Bucsics^1,19  Iain Bishop⁸  Marion Bennie^3,38  Christoph Baumgärtel⁶  Elina Asola^2,29  Rickard E Malmström^3,31  Jan Jones⁴  Inaki Gutiérrez-Ibarluzea^1,16  Eva Zebedin-Brandl^3,32  Parneet K Cheema²  Alexander E Finlayson^1,15  Brian Godman^3,38 

[1] Norwegian Medicines Agency, Sven Oftedals vei 8, 0950, Oslo, Norway;Sunnybrook Odette Cancer Centre, 2075 Bayview Avenue, Toronto, ON, Canada;NHS Greater Manchester Commissioning Support Unit, Salford, Manchester, UK;NHS Tayside, Kings Cross, Dundee DD3 8EA, UK;Ministry of Health, Republic of Croatia, Ksaver 200a, Zagreb, Croatia;Austrian Medicines and Medical Devices Agency, Traisengasse 5, Wien, Austria;University of Glasgow, Glasgow, Scotland, UK;Public Health & Intelligence Strategic Business Unit, NHS National Services Scotland, Edinburgh EH12 9EB, UK;Unit for Clinical Pharmacology, University Hospital Rijeka, Krešimirova 42, 51000, Rijeka, Croatia;University of Heidelberg, Institute of Pharmacology, D-69120, Heidelberg, Germany;Public Health School, The Medical Centre of Postgraduate Education, Kleczewska Street, 61/63, 01-813, Warsaw, Poland;London School of Economics and Political Science, LSE Health, Houghton Street, London WC2A 2AE, UK;HTA Consulting, Starowiślna Street, 17/3, 31-038, Cracow, Poland;Unitat de Coordinació i Estratègia del Medicament, Direcció Adjunta d'Afers Assistencials, Catalan Institute of Health, Barcelona, Spain;King’s Centre for Global Health, Global Health Offices, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK;Osteba Basque Office for HTA, Ministry of Health of the Basque Country, Donostia-San Sebastian 1, 01010, Vitoria-Gasteiz, Basque Country, Spain;State Agency of Medicines, Nooruse 1, 50411, Tartu, Estonia;Dutch Institute for Rational Use of Medicines, 3527 GV, Utrecht, Netherlands;Hauptverband der Österreichischen Sozialversicherungsträger, 21 Kundmanngasse, AT-1031, Wien, Austria;Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden;Institute for Optimizing Health Outcomes, 151 Bloor Street West, Suite 600, Toronto, ON M5S 1S4, Canada;INFARMED, Parque da Saúde de Lisboa, Avenida do Brasil 53, 1749-004, Lisbon, Portugal;National Centre for Pharmacoeconomics, St James's Hospital, Dublin 8, Ireland;Health Insurance Institute, Miklosiceva 24, SI-1507, Ljubljana, Slovenia;Faculty of Pharmacy, Comenius University and Faculty of Medicine, Slovak Medical University, Bratislava, Slovakia;Dental and Pharmaceuticals Benefits Agency (TLV), PO Box 22520 Flemingatan 7, SE-104, Stockholm, Sweden;Department of Healthcare Development, Stockholm County Council, Stockholm, Sweden;Kassenärztliche Vereinigung Hessen, 15 Georg Voigt Strasse, DE-60325, Frankfurt am Main, Germany;Pharmaceutical Pricing Board, Ministry of Social Affairs and Health, PO Box 33, FI-00023 Government, Helsinki, Finland;Barcelona Health Region, Catalan Health Service, Esteve Terrades 30, 08023, Barcelona, Spain;Department of Medicine, Clinical Pharmacology Unit, Karolinska Institutet, Karolinska University Hospital Solna, SE-17176, Stockholm, Sweden;Institute of Pharmacology and Toxicology, Department for Biomedical Sciences, University of Vienna, Vienna, Austria;IRDES, 10 rue Vauvenargues, 75018, Paris, France;NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Manchester M13 9PL, UK;Clinical Programs, Pharmacy Management, Horizon Blue Cross Blue Shield of New Jersey, Newark, USA;Liverpool Health Economics Centre, University of Liverpool, Chatham Street, Liverpool L69 7ZH, UK;Republic Institute for Health Insurance, Jovana Marinovica 2, 11000, Belgrade, Serbia;Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK;KU Leuven Department of Pharmaceutical and Pharmacological Sciences, 3000, Leuven, Belgium;Medicines Reimbursement Department, National Health Insurance Fund, Europas a. 1, Vilnius, Lithuania;Wissenschaftliches Institut der AOK (WIDO), Rosenthaler Straße 31, 10178, Berlin, Germany;INDOX Cancer Research Network, Cancer Epidemiology Unit, University of Oxford, Oxford, UK

关键词: Targeted treatments;    Reimbursement;    Rational use of medicines;    Health authorities;    Personalized medicine;    Pharmacogenetics precision medicine;    Healthcare policy;    Genotyping;    Genomics;    Drug development;    Biomarkers;   

Others  :  856944
DOI  :  10.1186/1741-7015-11-179

 received in 2013-01-15, accepted in 2013-07-09,  发布年份 2013

【 摘 要 】

Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer’s perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients.

【 授权许可】

   
2013 Godman et al.; licensee BioMed Central Ltd.

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