Outline
Introduction
Imagine a medicine that is customized according to your genes, lifestyle, and environment. Amazing right? This is Precision medicine which is a medication that is designed for each group specifically which has similar characteristics and is meant to increase the efficacy of medicines.
This approach is in contrast with the "one-size-fits-all" approach in which one type of medication is generalized and prescribed to all population. For example, the antiplatelet medications when prescribed after a recent heart attack is prescribed to all people who were recently diagnosed with heart attack.
Now, you may think that this is a very new concept. But in fact, it is not.
It all started in 1901, when Karl Landsteiner of University of Vienna found out that there are different types of blood groups which is the ABO blood group system. This concluded that each patient's biology is different.
What’s the connection between the ABO blood system and Precision medicine? As we know each person has a different blood group, Karl used the same blood the patient had for transfusion. This was effective! And showed that each blood transfusion is specific to an individual and varies among people.
How did it start?
Former President of the USA, Barack Obama started the initiative called Precision Medicine Initiative(PMI) and further invested a whopping $215 million into the All of Us Research program. In this study, many people from different race, ethnic, sex, and religion backgrounds are being studied. This study is still being continued.
Short term goals of Precision medicine
The National Institute of Health(NIH)
Identifying the new cancer subtypes(which is about 200)
Testing therapies
Help in expanding understanding of therapeutic response
Drug resistance
Combination therapy
Predicting and monitoring tumor recurrence(occurring again
The long term goals of Precision medicine
Establishing a system of customized medicine for millions of people
Innovating new approaches for detecting, measuring, analyzing a wide array of biomedical variables
Such as molecular, genomic, cellular, clinical, behavioral, physiological, and environmental
Testing these approaches in small pilot studies(randomized control trial; small scale study).
Utilizing the approaches in a wider population for a long period of time to generate novel information.
Why it hasn't been implemented yet?
This medication might be one of the best innovations of the 21st century, said the tech tycoon, Steve Jobs. But why hasn't it been implemented yet?
The technology to start this treatment is expensive, and these precision medications cannot be afforded by everyone. This might take a few years to even implement since the medications prices are elevated and also cannot provide these types of medications on a large scale.
What is the difference between precision medicine and personalized medicine?
Precision medicine approach is a treatment that is applicable to groups of people with familiar characteristics whereas personalized medicine approach is a treatment that is applicable to every unique patient.
Why is it unfair?
Precision medicine is one of the most important innovations in our century but it isn't all that fair. Since majority of the All of Us research program participants are white/Caucasian, this study wouldn't be fair to all other minorities. The research program would be increasing the accessibility of Precision medicines for white race which would lead to discrimination and a health gap among the U.S. population.
According to the data of 2020, another reason is that lot of people(29% of Americans) in the U.S. don't have health insurance because health check-ups, medications, and treatments are very expensive. This would lead to even more health gap among the population since the people who are taking Precision medicine for a long period of time are going to have greater advantage of having longer life span than the others who don't have access to proper heath care system.
Sources
“White House Precision Medicine Initiative.” National Archives and Records Administration, National Archives and Records Administration, obamawhitehouse.archives.gov/precision-medicine.
“An Overview of the NIH Precision Medicine Initiative.” National Institute of Minority Health and Health Disparities, U.S. Department of Health and Human Services, www.nimhd.nih.gov/about/legislative-info/clips/pmi.html.
“Harold on History: The Evolution of Personalized Medicine.” American College of Cardiology, www.acc.org/latest-in-cardiology/articles/2018/10/14/12/42/harold-on-history-the-evolution-of-personalized-medicine.
“What Are Some Potential Benefits of Precision Medicine and the Precision Medicine Initiative?: MedlinePlus Genetics.” MedlinePlus, U.S. National Library of Medicine, 18 Sept. 2020, medlineplus.gov/genetics/understanding/precisionmedicine/potentialbenefits/.
Anastasi, Vicki. “Precision Medicine: Overcoming Cost Challenges.” PharmaTimes, PharmaTimes Media Limited, 22 Oct. 2018, www.pharmatimes.com/magazine/2018/november_2018/precision_medicine_overcoming_cost_challenges.
Kim, Stephen. “What Is Precision Medicine.” Magellan Health Insights, 25 Oct. 2019, magellanhealthinsights.com/2019/10/28/what-is-precision-medicine/.
Mapes, Brandy M., et al. “Diversity and Inclusion for the All of Us Research Program: A Scoping Review.” PLOS ONE, Public Library of Science, journals.plos.org/plosone/article?id=10.1371/journal.pone.0234962.
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