The approach to target drugs for care will reduce not only costs but the time it takes to get needed pharmaceuticals, says William Dalton, MD, PhD, founding director of the Personalized Medicine Institute at the H. Lee Moffitt Cancer Center in Tampa, Fla., and CEO of M2Gen. "Ultimately, this approach in personalized medicine will reduce costs by getting the drugs right the first time," he says. His organization, along with the Sanford-Burnham Medical Research Institute in Orlando, Fla., and the 2,224-bed Florida Hospital, also in Tampa, have a personalized program partnership for research and clinical programs.
"Too often, people are treated with the same regimen, and only a portion of the patients will respond," Dalton says. "It's almost a trial-and-error approach. The personalized medicine approach increases the probability that patients will respond the first time, and that's good for everybody."
While the genomic costs are decreasing, some note that the reimbursement system for diagnostic tests has not evolved to accommodate the advances.
"The cost of testing, the jury is still out on third-party payers," comments Matthew Ferber, PhD, assistant professor of laboratory medicine and pathology at the Mayo Clinic, a 1,150-bed organization based in Rochester, Minn. He also is codirector of the Clinomics Transitional Program within the clinic's Center for Individualized Medicine. Ferber is planning a personalized medicine service line with an initial focus on cancer patients where physicians have been stymied in their care.
"While there has been some real success, it's too early for insurance companies to say this is the standard of care. There is still more work to do. Insurance isn't going to cover to perform the lab tests. But the technology is causing a paradigm shift. There may be no ROI right now; it's the ‘I' for investment. You are looking at the future where we need to be."
Smaller organizations may face the "financial burden" of building an infrastructure for personalized medicine, and "they might want to let it mature," Ferber adds. By engaging in partnerships with pharmaceutical companies, however, hospitals and health institutions may ease that fiscal burden.
Moffitt Cancer Center's Dalton acknowledges the journey toward personalized medicine is a complicated one.
"Our biggest challenge is not the technology," Dalton says. "The technology is there. We can sequence the entire genome, at a reduced cost. That's not the challenge. It's what you do with all this information; how do you learn from it?"