The rise of personalised healthcare in 2017

Research shows only a third of patients are familiar with personalised medicine – and only 11% have broached the topics with their doctor. Considering around 38% of patients with depression, 50% of arthritis patients, 40% of asthma patients and 43% of diabetic patients won’t react to the first treatment they’re prescribed, these statistics are concerning.

Experts in the field believe the knowledge gap around personalised medicine – and reluctance of some healthcare professionals to embrace it – is halting the advancement of healthcare systems.

What is personalised medicine?
Personalised medicine, also known as precision medicine, is an emerging practice of medicine that uses an individual’s genetic profile to guide prevention, diagnosis and treatment of disease. One of the foundations of personalised medicine is pharmacogenomics: using genetic biomarkers that influence drug response to guide drug therapy decisions for individual patients.

Historical approach
The lack of knowledge around personalised medicine is largely as a result of the ‘one-dose-fits-all’ approach used to treat diseases throughout history. Medicine has traditionally revolved around ‘standards of care’, which is believed to be the most effective treatment for the general population. Often, this is considered to be the most reasonable treatment, but has little to do with the patient specifically.

The findings from the Human Genome Project, released in 2003, gave momentum to the personalised medicine movement. The project revealed the DNA of any two individuals is 99.9% identical. Variations in the 0.1% of a person’s DNA, it was discovered, influence the genes that code for drug-metabolising enzymes or drug transporters. This means a significant portion of the population will each metabolise medications in a unique way to another patient.

Small change, big consequences
A small genetic variation in genes that control drug-metabolising enzymes also contribute to adverse events (unintended side effects). Genetic variants can cause drugs to be metabolised faster or slower, which means some patients have trouble inactivating a drug and eliminating it from their bodies, which can lead to an overdose.

Alternatively, other patients’ genetic variations will eliminate the drug too quickly, before it’s worked. It’s estimated that approximately 5% of hospital admissions are caused by adverse drug reactions. In low- and middle-income countries, this statistic is likely to be as high as 8%.

Costly practice
Adverse events have a strain on governmental healthcare systems. The Centre for Disease Control and Prevention has estimated that the healthcare system in the USA spends $3.4 billion on extra medication costs due to adverse events. These could be avoided to a large extent with the help of precision medicine.

Where to start
Another contributing factor to the knowledge gap around precision medicine may be the perceived cost involved with genetic testing. Most patients view genetic testing as a luxury for the super-elite – and consider the process invasive and lengthy.

South Africans considering genetic testing, however, now have affordable and non-invasive options that give them access to genetic testing. Medcheck is a pharmacogenomics test offered by local biotechnologists DNAlysis. The test involves a simple cheek swab done with an at-home test kit and couriered to a lab.

Once the results are analysed and a full report compiled, each patient has access to knowledge about their unique DNA, and can use it to work with their doctor in tailoring their prescriptions and medication. DNAlysis is pioneering the personalised medicine movement in South Africa with the Medcheck test, and making genetic testing as simple and accessible as possible. Soon, patients will even be able to complete the Medcheck test at Dis-Chem.

As the world of healthcare slowly shifts their focus to a personalised approach, South African healthcare professionals aren’t far behind despite what South Africans might believe. In years to come, personalised medicine will likely become the norm – saving time, money and lives in the process.