Cost of the Personal

An article in the Vancouver Sun discusses whether personalized medicine will lead to higher drug costs.

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The points made in this brief

The points made in this brief summary are reasonable as far as they go. But there are other mitigating factors. First, in some cases a molecular diagnosis of a rare genetic disorder may reduce patient management, in the sense that clinicians may reduce the use of futile interventions, which were otherwise used prophylactically in the absence of a true diagnosis. We have already seen examples of this at our hospital. Second, it is probably too early to know how individualized treatments will need to be for orphan diseases. For example, once gene replacement with engineered stem cells becomes routine (still probably decades away), perhaps costs per patient will be very low. Enzyme replacement is expensive because it is chronic, the 'drug' in this case a protein is not stable. That may not turn out to be the most commonly used therapeutic approach in the future. I certainly foresee a short-term cost issue, but it's too soon to know whether it will continue long term.