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Precision Medicine as the Future of Medicine: Benefits and Challenges

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"I'm a young medical doctor with refined research skills, having worked with various people in the medical field and beyond".

M.D. - Bachelor Of Medicine And Bachelor Of Surgery. The University of Nairobi, Kenya, graduated in 2020.  Certificate In Computer Applications, certified from Kenya Institute of Management 2014.

Precision medicine, a recently developed technique to diagnose, treat, prevent, and cure diseases, considers the individual’s unique genetic, lifestyle, and environmental factors when designing therapeutic interventions. This new development promises a lot of benefits to both patients and healthcare practitioners. However, it also brings to the fore various challenges in healthcare practice and some new problems. This paper looks at the benefits of precision medicine and discusses some of the challenges that may result from adopting it as the conventional form of practice.

Benefits of Precision Medicine

Knowledge about the influence of genetics and genomics on health, illness, and the response to drugs has been steadily increasing since the Human Genome Project’s completion in 2003. The mapping of the human genome has allowed scientists to understand how different genes interact to produce disease for communicable and non-communicable diseases. Gene-based diagnosis, a prominent diagnostic tool in precision medicine, was thus developed for various conditions. This method has both high sensitivity and specificity, making it the ideal diagnostic tool. Besides, diagnosis is made before the disease’s signs and symptoms become manifest instead of relying on clinical diagnosis. The early detection of illness presents an opportunity for treatment before much damage, thus reducing the chances of disability. 

Furthermore, the field of preventive medicine has revolutionized. For instance, in infectious diseases, genes that confer susceptibility to pathogens can be knocked out to confer life-long immunity against the agent. The same technique is used for non-communicable diseases such as diabetes. Additionally, defective genes can be sliced out of the genome and replaced with normal genes. This promises a long and happy life free from illnesses. The shift from reaction to prevention also has significant effects in reproductive health. Prospective parents can have their embryos screened to detect any malformations and defects before the pregnancy starts or during the early stages of pregnancy. Defective embryos are destroyed and pregnancies with a high risk of defects terminated. The parents can now be sure that they are going to have a baby free from congenital defects. This will save many parents the agony of raising children they might not have liked to have. They will also select the best traits such as intelligence and immunity to infections that they would love their children to have with further development.

Although age is just a number, it makes a massive difference in many facets of life for a long time. Take, for instance, the choice of clothing between a centenarian and a teen; they are worlds apart! This difference should be maintained in other fields such as therapies. Yet, for some peculiar reasons, the medications offered to centenarians and teens while treating a similar condition are not so different. Why would that be the case, you may wonder, but might not be able to explain? 

The field of precision medicine brings you the answer. The answer, you may expect it to be complicated, is not, is that medications should consider the differences. The traditional method of producing drugs, “the one size fits all,” has medicines using population averages. Therefore, the medication only works for a part of the population: Pharmacogenomics, a method of producing drugs that consider the unique genetic variations among individuals. The medicines are tailored for the individuals: to be more effective and reduce adverse events. Additionally, it will make the development of new drugs easier and cheaper by reducing the time and cost of conducting pharmaceutical clinical trials. The elimination of trial and error prescription methods will also lower healthcare costs since patients will not have to try several medications before finding the one that works.

Challenges of Precision Medicine

In as much as precision medicine seems to be a panacea, it is not free of challenges – new and old. Some of these challenges are:

Cost – The practice of precision medicine banks on the development of sophisticated technology. Some of this technology, such as whole human genome sequencing, is now available while other technological tools are still being developed. Despite the cost of genome sequencing coming down significantly since 2003, it is not readily affordable for most of the population. The reliance on the internet also increases the cost of operationalization. There are still places with poor internet connections and will therefore lag. Setting up this infrastructure makes the initial price too high. In addition, personalized medicine will require the development of new drugs. Moreover, the drugs will have to be very diverse to cater to the many variations present in the population.

Privacy of Data – Information on the genetic makeup of individuals is being collected to guide the personalization of therapies. This information will reveal very private information about people, including any kinds of gene defects. The information must be available to many people for them to use it. However, there is a risk of the data being used by different organizations to start profiling and segregating people. The security of the genetic information should thus be ensured.

Ethics – The unequal distribution of resources threatens universal access to healthcare. Although precision medicine offers to solve this by personalizing care for each individual, the costs to be met will increase the existing inequalities. The issue of editing genes is also another contentious one. Many conservative people contend with it, claiming it is playing ‘god’. This is also applicable to embryo selection and prenatal gene testing. The choice of which child should live is not an easy one to make. Selecting out embryos of those with disabilities such as Down Syndrome makes people feel is one science cannot answer.

In conclusion, precision medicine offers the best shot at solving many of the current medical practice problems. The elimination of adverse drug reactions, avoidance of wastage of medication, and the detection of illnesses even before they start manifesting are but a few of the benefits. However, several challenges such as the high cost, the privacy of people’s data, and the various ethical questions should be addressed before it is adopted as the mainstream medical practice.

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