An essential paradox of The Creative Destruction of Medicine is that personalized medicine will avoid the Vioxxes of the future by tailoring drugs, therapeutics, and devices to the targeted populations that will be effectively treated, yet it does not adequately explain how the U.S. healthcare system, in its critically impacted current condition, will manage to pay for these new personalized solutions.
Topol supposes that the power of the Internet, the digitization of the human body including genomics, and the reduced need for large-scale populations for clinical trials, will eliminate sufficient waste and save sufficient money to make such personalized medicines affordable and cost-effective. I guess Topol thinks the free market, radiating from today's concierge medicine, will take care of the rest.
I am not so confident. My basis for saying so does not originate solely in my 220 hours of study of clinical trials, although my study of that badly broken system of innovation was illuminating.
Instead, I am leery because some of the assurances from academia and industry sound eerily reminiscent of assurances of the tech industry of the 1980s and 1990s that technology advancements would vastly increase worker productivity.
The fact that productivity gains remained largely flat through a period of vast investment in technology improvements meant that predicting such gains solely on the basis of Moore's Law, and the proliferation of sensors everywhere, is a risky business.