Abstract

Personalised medicine (PM) has the potential to increase therapeutic effectiveness, reduce side effects and lower cost. The identification of biomarkers predictive of the clinical response to specific treatments in subsets of patients became reality for a variety of diseases. However, a better understanding of the benefits and limitations needs to be developed at the level of the general public as well as at the level of an individual patient. The upcoming ability to characterize each patient from the genetic point of view in a comprehensive manner is believed to have the potential to transform medicine, thus enabling accurate prognosis as well as a treatment outcome prediction. However, PM holds both promise and cause for concern. Although PM promises that an individual’s genetic information may be increasingly used to prioritize medical decision making, it raises in parallel fears and questions as to whether such use could be inequitable. Thus, there are many thoughts whether the use of individual genetic information in the delivery of health care can be a cause for concern, as it may lead to genetic discrimination and other problems such as with employers and private insurance companies. Finally, the main pitfall of predictive tests for complex disease remains the putative lack of proven medical benefit. A better understanding of the benefits PM will have to be developed at the level of the general public as well as at the level of an individual patient; which will also reassure people that their genetic data is used appropriately to choose therapeutic protocols and drugs.

Highlights

  • Precision or Personalized medicine (PM) proposes to customise healthcare, with respect to medical decisions, practices, and/or products by tailoring these to the individual patient

  • The other main concern is about using genetic data in relation to insurance with the fear that genetic information can be used by insurers to deny, limit or cancel health insurance policies

  • Legal constraints The debates initiated by the insurance related issues are still continuing and more laws, bills and agreements have and keep being produced in response to public pressure, notably in the US [9] with bills being introduced in many sessions of the Congress (Genetic Information Non-discrimination in Health Act of 2003, S. 1053, 108th Cong.) and optimal solutions are still being thought

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Summary

Introduction

Precision or Personalized medicine (PM) proposes to customise healthcare, with respect to medical decisions, practices, and/or products by tailoring these to the individual patient. PM has the potential to revolutionize medical care by utilizing an improved understanding of genetics to allow for better diagnostic tests, greater predictability of disease course and improved patient safety by selecting the right drug for the right patient and the proper dosage and timing to reduce adverse effects.

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