Can We Afford Personalized Medicine?

Few movements in recent years have come along with the force and acclaim of personalized medicine. Its aim, in the words of one of its founding fathers, Leroy Hood, is to “find the right treatment for the right person at the right time.” The combination of the two fields of genomics and proteomics (the study of proteins) is the engine behind the movement, and its main attribute, called P4 medicine, is that it will be personalized, predictive, preventive, and participatory. Already making its mark in cancer diagnosis and care, personalized medicine aims to understand us in our genetic health and disease particularities, moving beyond the scientific generalities marking current medical practice. As a PriceWaterhouseCoopers study put it, “While still in its early stages, personalized medicine is steadily emerging as the new healthcare paradigm.”

But will it raise or lower the cost of health care? Hard data is scant, in great part, no doubt, because personalized medicine still has little experience or history behind it. But there are claims it can lower costs, and on what seem to be reasonable grounds – that savings in cancer care, for instance, can come from pinpointing treatments that will or will not be beneficial.

Yet while examples of possible savings have been cited, given the scope and ambition of the personalized medicine movement its overall cost impact is far less clear. It is worth keeping mind the well-established estimate that some 50% of annual cost increases come from new technologies or the intensified use of old ones. A 2008 Congressional Budget Office study found that “examples of new treatments for which long-term savings have been clearly demonstrated are few.”

The PriceWaterhouseCoopers study, designed as a guide to investors and business leaders in making the most of the large profits that are emerging, inadvertently paints a less-than-reassuring picture about whether this technology will be one of those few. “The U.S. personalized medicine market,” it says, “is estimated at about $232 billion and is projected to grow at 11% annually, nearly doubling in size by 2015 to over $450 billion.” Now unless I have missed a basic point about American health care, what is a source of market growth and profit for some is a source of costs for others. Someone or other has to pay for those benefits: private insurers, the government, or out-of-pocket for consumers. The study does not mention that point.

A few other points jump out (at least to a cost maven like me), presented as

business tips:

  • “capitalizing on preferential use of and premium pricing for drugs of proven benefit”
  • “a higher rate” of “repeat prescribing”
  • “the emergence of ‘niche busters’” – drugs targeted to small populations but carrying a high price tag – “to replace some of the income lost as blockbusters go off patent”
  • “strategies to broaden the definition of what is considered ‘health’”

No doubt this is savvy profit-enhancing advice, of a tried and true kind – “premium pricing,” “repeat prescribing,” and “high price tag.” What’s new is the recommendation to broaden the definition of heath. Many years ago I wrote an article against the 1946 WHO definition of health. “Health,” it said, “is a state of complete physical, mental and social well-being and not merely the absence of infirmity.” The WHO eventually got rid of that preposterous notion, but the medicalization of just about any and all human complaints, physical and mental, has been underway for decades. Personalized medicine opens up some new horizons for that ubiquitous virus.

Neither the Affordable Care Act nor the market-oriented alternatives offered by conservatives who would like to overthrow it bring into their calculations the likely economic impact of personalized medicine. Perhaps it has just been overlooked. But it just the kind of technological development that is most likely to bring distress and maybe havoc to our health care system. The danger is that all the health benefits and the business opportunities it portends will turn out to be true.

No combination of obvious public benefits and industry profits is more potent than that. It could turn out to be good “value for money,” but as I contended in an earlier blog that kind of value is not necessarily affordable. How to say no to those medical technologies that everyone likes for their personal health and industry profits, but that may turn out to be outrageously expensive for the health care system, is the final and most vexing dilemma about cost controls.

My short answer to that dilemma is this: there will always be new and usually expensive ways of bringing us health benefits we desire. We will all get sick of something or other no matter how great our medical progress, and there will no less always be ways for medical research and technological innovation to combat our illnesses. But at some point we will have to acknowledge that it is ultimately a losing game – at least if one is interested in controlling health care costs. The medical bubble is bursting.

Daniel Callahan, co-editor of the Health Care Cost Monitor, is the author most recently of Taming the Beloved Beast: How Medical Technology Costs are Destroying Our Health Care System.

| Print Print | Download as PDF | 69 Comments
The Health Care Cost Monitor is made possible by Supporting Members of The Hastings Center. Please give today.
  • Recommend this Post on Facebook


  1. voyance says:

    I used to be suggested this web site by way of my cousin.
    I am no longer certain whether or not this publish is written by means of
    him as nobody else know such distinct about my trouble.

    You are amazing! Thanks!

  2. Louann says:

    Have you ever thought about adding a little bit more than
    just your articles? I mean, what you say is valuable and all.
    Nevertheless think about if you added some great photos or videos to
    give your posts more, “pop”! Your content is excellent but with images and video clips, this site could certainly be one of the very best in its niche.
    Superb blog!

    My web page :: アウトレット コンフォートシューズ

  3. Hmm it appears like your site ate my first ckmment (it was extremely long) so
    I guess I’ll just sum it up what I submitted and say, I’m thkroughly enjoying your blog.

    I too am an aspiring blog blogger but I’m still new to the
    whole thing. Do you have any recommendations for newbie
    blog writers? I’d really appreciate it.

  4. Do you have a spam issue on this blog; I also am a blogger, and I
    was wanting to know your situation; many of us have developed some nice methods and we are looking to trade techniques with other folks, why not
    shoot me an email if interested.

  5. art baking says:

    Valuable info. Fortunate me I found your web site by chance, and I’m surprised why
    this accident did not came about in advance! I bookmarked it.

  6. This page really has all of the info I needed concerning
    this subject and didn’t know who to ask.

  7. Thanks for your personal marvelous posting! I genuinely
    enjoyed reading it, you could be a great author.
    I will always bookmark your blog and will eventually come back very soon.
    I want to encourage you to ultimately continue your great writing, have a nice weekend!

  8. You’re so interesting! I do not suppose I’ve read through anything like that before.
    So wonderful to find another person with some genuine thoughts on this topic.
    Really.. thanks for starting this up. This web site is something that’s needed on the internet,
    someone with a little originality!

  9. voyance says:

    It’s actually very complex in this full of activity life to listen
    news on Television, thus I only use the web for that reason, and get the newest news.

  10. repair says:

    Hello would you mind letting me know which webhost
    you’re using? I’ve loaded your blog in 3 completely different internet browsers and I must say this blog loads a lot quicker then most.
    Can you suggest a good web hosting provider at a honest price?

    Thanks, I appreciate it!

  11. I absolutely love your blog and find most of your post’s to
    be what precisely I’m looking for. Does one offer guest writers to write content for yourself?
    I wouldn’t mind producing a post or elaborating on many of the subjects you write regarding here.
    Again, awesome web site!

  12. Sweet blog! I found it while browsing on Yahoo News.
    Do you have any tips on how to get listed in Yahoo News?
    I’ve been trying for a while but I never seem to get there!

    Appreciate it

    Feel free to surf to my page eugene carpet cleaing

  13. Hello, I want to subscribe for this web site to take most recent
    updates, therefore where can i do it please help.

  14. Hey i really loved the layout. Thought one thing was really cool.

    my homepage :: discount hair Bow

  15. We are a group of volunteers and opening a new scheme in our community.
    Your website offered us with valuable info to work
    on. You’ve done an impressive job and our whole community will
    be grateful to you.

  16. Tawanna says:

    Great info. Lucky me I found your blog by accident (stumbleupon).
    I have saved it for later!

  17. No matter if some one searches for his necessary thing, thus he/she wishes to be available that in detail,
    therefore that thing is maintained over here.

  18. We have been recently looking for a post distinctive like this for a long time and only
    happened to encounter your webpage through recommendation by my editor.
    Brilliant piece of content!

    Feel free to visit my homepage — e liquid suppliers

  19. Andrew says:

    Asking questions are genuinely good thing if you are not understanding anything totally, however this post gives fastidious understanding even.

5 Trackbacks

  1. By Headline Scan « Health Watched on May 18, 2011 at 1:38 pm

    […] Can We Afford Personalized Medicine? […]

  2. […] to PriceWaterHouseCoopers, the personalized medicine market is expected to reach $450 billion by 2015, Duncan said. And an increasing number of companies are going after the opportunities. The field […]

  3. […] to PriceWaterHouseCoopers, the personalized medicine market is expected to reach $450 billion by 2015, Duncan said. And an increasing number of companies are going after the opportunities. The field […]

  4. […] to PriceWaterhouseCoopers, the personalized medicine market is expected to reach $450 billion by 2015, Duncan said. And an increasing number of companies are going after the opportunities. The field […]

  5. […] medicine is the place where retail and healthcare collide. It’s also a market that’s about to double in size to $450 billion by 2015. Retail CIOs will need to enable new technologies in brick-and-mortar […]

Post a Comment

Required fields are marked *. We will not publish your email address.


You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>