Biotech Values

[Biowatch]

Some thoughts on personalized medicine & testing

Yes by testing, big pharma companies might give up 50% to 90% of the market for a drug if only 10% to 50% of the potential patient population would benefit from it.

The big flip side is that drugs with serious side effects in only 1% to 3% of the patients population can get pulled from the market completely. For example a drug with $ billions in sales might get pulled off the market completely if only a few patients in a thousand suffer kidney failure. In this case it would definitely be worth it to a big pharma to have a test to screen out those patients that might have severe reactions. (It might also help them avoid huge lawsuits.)

The cost of genetic tests is a factor if not covered by insurance. Prenatal screening can test for a variety of possible hereditary diseases, but most people don't bother unless there is a strong family history of the disease.

Myriad Genetics (MYGN) was the first to test for certain breast cancer genes, but sales were slower than expected at first because tests were expensive, didn't pick up every type of hereditary breast cancer, and people were afraid that health insurance would be more expensive if they tested positive.

For diseases with no "good" treatment, people may not bother getting tested.

We don't always know what to test for to predict who will benefit and who will be harmed by a given drug, and throwing drug combinations into the mix makes it that much harder.

We don't always know how different drugs or other conditions interact. (For example, did you know that grapefruit juice, but not orange juice, slows the metabolism of certain drugs with deleterious consequences?)

Still, personalized medicine will be more common in the future as we learn more about what genes are involved in certain diseases and which are amenable to treatment by specific drugs, and as these tests get cheaper and easier to do.

I like the work of Eric Lander and others, and I think the ability to screen many genes or their expression levels simultaneously is a huge step forward from the old days.