The Role of the Healthcare Consumer in Personalized Medicine

I have posted a number of notes about personalized medicine over the past three years that Lab Soft News has been in existence. In one of these posts (see: Continuing Discussion of the Role of Lab Medicine in Personalized Medicine), I presented the following definition of the term:

Personalized medicine [involves the] use of information and data from a patient's genotype, or level of gene expression, to stratify disease, select a medication, provide a therapy, or initiate a preventative measure that is particularly suited to that patient at the time of administration.

Much has been written about the topic of personalized medicine since the posting of my blog note, but the following comment by Lena Chow in her City of Paris blog struck me as insightful and on-point (see: Personalized Medicine: So Close Yet So Far). Boldface emphasis is mine.

[T]argeted therapy is only one component of personalized medicine. Much of the unharnessed power of personalized medicine—defined more broadly as individualized healthcare based on genetic variations—lies in identifying and understanding risk factors and developing a plan for mitigating those risks. This shift toward a focus on wellness from our current mindset of intervention and treatment requires more than a change in attitude among consumers and physicians. It demands new health policies that provide financial rewards for wellness. Toward that end, it will not be surprising to see an increasing role for the consumer as the seeker of the additional information that genetic testing can provide. In fact, recent history with BRCA1 and BRCA2 testing, and now the emergence of companies such as Navigenics and 23andMe, point to consumers’ appetite for personal genetic information and, more important, their willingness to pay. Perhaps the consumer will be the one leading the charge as champion and advocate for personalized medicine?

Here is a list of the key elements of her interpretation of the term personalized medicine that I have modified slightly based on my own views:

• Targeted therapy constitutes only one facet of personalized medicine; the term needs to be extended in light of new developments in medical science and healthcare.
• It can be defined as individualized healthcare based on identifying genetic variations, understanding a patient's risk factors, and developing a therapeutic plan for mitigating those risks.
• Although often omitted, the concept of wellness also needs to be incorporated into the definition of personalized medicine.
• In the pursuit of wellness, healthcare consumers need to be better informed about their health status; this can be accomplished, in part, using consumer-oriented healthcare web sites (see my previous notes about Health 2.0).
• An important part of this knowledge acquisition will also be consumer-initiated web-based genetic/genomic testing services (see my previous notes about direct-access-testing, also known as consumer-directed-testing).
• A set of financial rewards should be offered for the individual consumer's pursuit of wellness, perhaps generated as some percentage of the healthcare costs avoided by achieving a state of wellness.
• By merging the concepts of personalized medicine and wellness, the power and effectiveness of the healthcare consumer can be more effectively harnessed.