The Precision Medicine Chimera
The US government recently issued an appeal for ideas to advance a “precision medicine initiative,” which will channel millions of dollars toward efforts to tailor clinical treatment to individual patients. But, despite its appeal, personalized medicine is unlikely to do much to improve public health.
BOSTON/NEW YORK – US President Barack Obama’s administration recently issued an appeal for ideas to advance its “precision medicine initiative,” which will channel millions of federal research dollars toward efforts to tailor clinical treatment to individual patients. The idea of personalized medicine, which builds on dramatic advances in genetics and molecular biology, certainly sounds appealing – and not only in the United States, but also in Britain and elsewhere. Unfortunately, the assumption that precision medicine will benefit public health by improving clinical practice does not hold up.
Much of the scientific leadership in the US, particularly at the National Institutes of Health, has thrown their enthusiastic support behind Obama’s initiative. According to Harold Varmus, director of the National Cancer Institute, and Francis Collins, director of the NIH, such “a broad research program […] to build the evidence base needed to guide clinical practice” is precisely “what is needed now.”
But in focusing on the detection and treatment of diseases at the individual level, precision medicine neglects broader health patterns. When one takes a closer look at the health of populations – in particular, the poorer segments of society – “what is needed now” looks quite different.