Francis Collins on CER and Personalized Medicine

A Kaiser Health News reporter recently spoke with Francis Collins about comparative effectiveness research, the National Institutes of Health, and how they "'should be right in the middle' of the conversation about an overhaul of the nation's health system." In a Q&A style interview, Collins addressed questions about the future intersection of personalized medicine and comparative effectiveness research as proposed by President Obama. When asked whether he fears that CER might infringe on recent advances in personalized medicine, Collins says that the "personalized medicine strategy and CER strategy are part of the same question. ... There will often be more than one therapeutic intervention, so you have to compare them. But you also want to know what's different about the individual that might have an influence on that answer." In addressing concerns about communicating genetic information to the public, Collins says there will be great opportunities for behavioral scientists to examine what people do with their new-found knowledge. For example, Collins says that after having his genome sequenced — and discovering his risk for diabetes — he changed his diet, enrolled in an exercise program, and lost 25 pounds. "Now, I should've done that anyway and that's part of the thing that diffuses the conversation," he says. The key, he says, is that personalizing recommendations is essential. "You wouldn't go into the shoe store and just pick shoes off the rack without noticing if they were your size and yet, oftentimes with medical recommendations, that's kind of what we've had to do because it was the best information we had," he says.