In the New York Times, Dr. Michael C Joyner argues that genetic medicine is disappointing and unworthy of increased research funding.
Given the general omerta about researchers’ criticizing funding initiatives, you probably won’t hear too many objections from the research community about President Obama’s plan for precision medicine. But I am deeply skeptical. Like most “moonshot” medical research initiatives, precision medicine is likely to fall short of expectations.
Dr. Joyner cites a lack of progress in several highly promising areas, including diabetes. What he does not acknowledge is that the genetic tests PGXL performs are providing important guidance in pain management, cardiovascular care, the treatment of depression and others.
It is in the nature of new technologies that value does not emerge evenly and simultaneously across all promising applications. But in certain situations, there is no doubt that genetic testing improves care. Medicare has studied and declared genetic testing medically necessary as part of the treatment of colorectal cancer, lung cancer, treatment-resistant depression and myocardial infarction. Genetic testing is guiding therapeutic choices for chemotherapies, antidepressants and anti-platelet agents to both identify the best medicine for that particular patient and to save money.
As Dr. Joyner pointed out, genetics is more complicated than we had imagined. Where we once assumed that the keys to effective treatment might lie in a few discreet genes, we have learned that efficacy is often determined by the interplay of several different genes. (That’s why PGXL is rolling out a genetic panel that gives physicians a 360 degree view of their patient’s medication response.) Like digital photography resolving more and more points of light, genetics will discern and capture more detailed genetic information at decreasing cost.