Personalized Medicine: How To Choose A Practitioner And What To Expect
Personalized medicine—also called “precision medicine”—is an emerging healthcare practice that takes an individualized approach to diagnosing and treating patients. Rather than giving the same medication or treatment to Persons X, Y, and Z, personalized medicine uses refined diagnostic testing and takes into account their unique physiology and genetic profile to determine a unique treatment approach.
Just as one diet isn’t right for everyone, neither is one treatment plan. With personalized medicine, doctors and practitioners can take a look at your biomarkers or genomic data and figure out which treatments would work best with your genetic and physiological makeup.
What Are the Benefits of Personalized Medicine?
There are several advantages to utilizing personalized medicine. Some of the leading benefits include:
- Reduced likelihood of adverse events. By using genetic or physiological data, healthcare practitioners can identify if you are at a higher risk of adverse events from a certain medication or treatment.
- Tailored treatment plans. Tailoring interventions can lead to more effective and efficient treatments, as each will be designed based on your unique genetic profile.
- Focus on pharmacogenomics. Doctors will be able to prescribe the drug (and dose) that is most likely to work best for you, as how you respond to a drug is highly variable and dependent on your biology, physiology, and DNA. If your doctor knows your genes, they can predict how you’ll respond to or metabolize certain drugs, choosing the most effective ones for you.
- Improved outcomes. Doctors can choose treatment plans that are more likely to work for you based on your biology, increasing the likelihood of better outcomes.
- Disease prevention strategies. Genetic testing can identify if you are at higher risk of certain diseases and lead you down a path of preventing that disease.
- Earlier disease detection. Diagnostics can also help detect diseases earlier, leading to more timely and effective interventions.
- Potential cost savings. Although there may be more cost upfront, you can save a lot of money in the long run by detecting diseases earlier and avoiding unnecessary or ineffective treatments.
- Informed and empowered patients. By learning more about your genetic makeup and physiological profile, you can feel more empowered about your healthcare, treatment options, and medications, as well as take proactive steps to improve your overall health.
- Rare or advanced diseases. People with rare or advanced diseases typically don’t have the luxury of trying out several different medications over time. Personalized medicine can help to more quickly identify any underlying genetic mutations responsible for these diseases, and, therefore, the medications to treat them.
What to Expect With Personalized Medicine
The main component of personalized medicine is getting DNA testing done, which is less scary than it sounds. Genetic testing typically involves giving a sample of blood, saliva, or skin cells and sending it to a lab, where scientists can screen for genetic disorders or mutations. Genetic tests typically only screen for one or two specific disorders at a time, which can be helpful if you have a disease that runs in your family and want to see your risk, for example.
A more comprehensive approach is sequencing your entire genome, which is your complete set of DNA, including SNPs (single nucleotide polymorphisms)—genetic variations that can influence health, disease, drug response and other traits. More and more companies are coming out with relatively affordable genome or DNA sequencing testing kits, making it easier and more accessible to get your genetic data to your doctor. In the future, it’s likely that full genomic datasets will be a part of everyone’s medical record.
Even without genomic testing, there are other ways to implement precision medicine, including looking at biomarkers and blood testing. For example, using a continuous glucose monitor (CGM) can provide 24/7 blood glucose monitoring, allowing doctors to precisely dose insulin in people with blood sugar regulation disorders. Biomarker testing can also help doctors keep an eye on any risk factors for disease or accelerated aging, including biological age testing.
A recent and interesting study that came out in July 2023 used biomarker-based precision medicine to determine which obese adults responded best to a weight loss intervention. The researchers analyzed serum-based metabolic and microbial profiles—a field of precision medicine known as metabolomics. They found that people who lost weight (“responders”) had significant differences in their metabolomic profiles—especially in markers related to caffeine metabolism—compared to non-responders. Specifically, people with those metabolic markers lost 3.6 times more weight than those without. Information like this can help doctors or dietitians know ahead of time if a certain weight loss or diet plan will work—or not—for somebody.
How to Find a Personalized Medicine Practitioner
As precision medicine is emerging in popularity, it’s now becoming easier to find healthcare practitioners in this field. You can search your location on MDVIP, a national network of primary care doctors who focus on delivering personalized medicine and preventive care. Plus, most hospitals affiliated with medical schools or universities now have personalized medicine programs, like the UCLA Institute for Precision Health (IPH), for example.
You can also enroll in research programs to advance the field of precision medicine, such as The All of Us research program. Led by the National Institutes of Health, this program plans to enroll over one million U.S. volunteers that will provide blood, urine or saliva samples for lab and DNA testing to build the most diverse health and genetic database in history.
Downsides of Personalized Medicine
While there are plenty of advantages of utilizing genome-based personalized medicine, there are a few downsides to consider.
First, genetic testing is more accurate for Caucasians than other groups. According to the Keck School of Medicine at USC, genetic testing accurately determines a Caucasian’s risk of disease with a false positive of 10%, while the same testing for Hispanics leads to a false positive of 60%. This is likely because the majority of medical research and clinical trials with genetic testing has been done with Caucasian volunteers, a huge disparity that needs to be rectified.
Another downside is the cost. While genetic and genome testing has gotten significantly more affordable in recent years, it can still be prohibitive for many. Genetic tests for single diseases or mutations can run in the $100-400 range, while whole genome sequencing can cost $1,000-2,500. Oftentimes, these tests are not covered by insurance. An often-more-affordable option is direct-to-consumer DNA sequencing (like SelfDecode, for example, which provides genotype results for 83 million SNPs and DNA traits for a few hundred dollars).
There are also ethical concerns. As this is a relatively new field, many people wonder about the privacy concerns about companies collecting and analyzing personal genetic data. Plus, some diseases or conditions do not have a strong genetic basis, and may be better treated with lifestyle interventions or traditional treatments. Lastly, if you don’t have an educated provider to go over your results, it can be challenging to interpret and apply the genetic data effectively.
Key Takeaways
Personalized medicine is an exciting field that would have been impossible to imagine just a few decades ago. With benefits like tailored treatment plans, more effective pharmaceutical choices and dosages, reduced risk of adverse events, and earlier disease detection, it’s easy to see why so many patients and practitioners are on board with precision medicine.
However, there are some downsides to consider, and balancing the potential benefits with ethical considerations, racial disparities, privacy concerns, and false positives is essential for personalized medicine to be successful in the near future.
References:
Cutter GR, Liu Y. Personalized medicine: The return of the house call?. Neurol Clin Pract. 2012;2(4):343-351. doi:10.1212/CPJ.0b013e318278c328
König IR, Fuchs O, Hansen G, von Mutius E, Kopp MV. What is precision medicine?. Eur Respir J. 2017;50(4):1700391. Published 2017 Oct 19. doi:10.1183/13993003.00391-2017
Lynch DH, Rushing BR, Pathmasiri W, et al. Baseline Serum Biomarkers Predict Response to a Weight Loss Intervention in Older Adults: A Pilot Study. Metabolites. 2023;13(7):853. Published 2023 Jul 17. doi:10.3390/metabo13070853
NIH News in Health. Personalized Medicine: Matching Treatments to Your Genes. 2013. https://newsinhealth.nih.gov/2013/12/personalized-medicine