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Cost of the Personal

While genome sequencing may enable more personalized medicine, an article in Vancouver Sun examines how it may also lead to more expensive drugs. Because therapeutics targeted against certain genetic mutations may only then be effective in a sliver of the population, Randy Shore writes in the Sun that such 'orphan drugs' could command prices ranging between $100,000 and $1 million a year for each patient.

"When only a handful of people benefit from a drug, odds are that it will come with orphan pricing to cover all the development costs with relatively few prescriptions," Larry Lynd, a pharmaceutical sciences professor at the University of British Columbia and member of a BC Ministry of Health expensive drug and rare diseases advisory committee, tells him.

Shore notes that the Canadian provinces are already grappling with the cost of the cystic fibrosis drug Kalydeco, which may help patients with certain CF gene mutations, but costs $300,000 a year. Provincial health plans, Shore notes, are not covering the treatment.

"Why all the fuss about diseases that affect one of thousands? Can't we afford to support a handful of people who need expensive drugs?" he says.

Lynd tells him that there are thousands of rare diseases and that as many as one in 12 people may be affected. At those numbers, the costs climb quickly.

"Every major advance in medical technology has come with substantial cost increases, but few people would look back on the introduction of antibiotics or kidney transplants and say the price was too high," notes Mary Anne Bobinski, dean of the faculty of law at UBC. "Genetic understanding may increase costs for some treatments, but not in a way that is inconsistent with other types of medical advances that society has had to digest."