Progress of Personalized Medicine Raises Question about Coverage, Morals

As the fields of medicine and technology continue to advance, the intersection of these two fields promises great potential. Personalized medicine has the power to look into an individual’s future and better predict susceptibility to conditions and diseases, giving them the power to better prepare for the possibilities. However, as this area of medicine continues to develop, moral questions abound.

For instance, at which point should personalized medicine be made available to the masses at an affordable rate? And at what point do insurers begin covering those consumers that are aware of a family predisposition to, say, breast cancer? Testing is getting to a point now where there may be ways for consumers to learn early in a pregnancy that their child had a greater potential to be autistic or homosexual. Art Caplan, PhD, division of medical ethics, department of population health, New York University, recently spoke with Philly.com about some of these issues, saying that “"We can now test a mother's blood as soon as 6 or 7 weeks into a pregnancy," he said. "That brings some big moral issues,” said Dr Caplan, adding that these tests “we better get ready for panic, disruption and trouble.”

Speaking about the potential of personalized medicine being made available at an affordable rate to consumers, Dr Caplan believes that genetic testing is not something everyone should consider:

“If you have a history of genetic disease, for instance, if breast cancer runs in your family, or if you have a cancer, I would ask a doctor for a test. For someone who says ‘I woke up today, and think I better get a gene test’ for no specific reason, I don't think we're there yet.”

Despite the uncertainty of future coverage for genetic tests, it is something that is top of mind for payers. In a recent survey conducted by Xcenda, 80% of the payers who responded said that “prediction of response to an agent” and “getting effective therapy the first time” are the most clinically important uses of personalized medicine. In a recent Xcenda webcast, Mark Green, MD, chief medical director and vice president, Oncology Insights, and Andrea Bare, MBA, senior director, Payer Market Insights, offered their perspectives on personalized medicine and how its use will impact pharmaceutical manufacturers in a healthcare environment focused on quality and cost containment. To register and view that presentation, which included discussions on the nomenclature of personalized medicine and what this implies for stakeholders; the juxtaposition of payer and community oncologist perspectives on personalized medicine; and key lessons as they relate to the oncology space, please click here.

Around the Web

Spitomics: The Promise and Perils of 'Personalized' Medicine [Philly.com]

Personalized Medicine: Clinical Decisions and Payer Perspectives [Xcenda]