Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jan 4;7(1):3.
doi: 10.1038/s41698-022-00343-y.

Precision medicine: affording the successes of science

Christine Y Lu  1 , Vera Terry  2 , David M Thomas  3
Affiliations
Review

Precision medicine: affording the successes of science

Christine Y Lu et al. NPJ Precis Oncol. .

Abstract

Science has made remarkable advances in understanding the molecular basis of disease, generating new and effective rationally-designed treatments at an accelerating rate. Ironically, the successes of science is creating a crisis in the affordability of equitable health care. The COVID-19 pandemic underscores both the value of science in health care, and the apparently inevitable tension between health and the economy. Drug development in ever-smaller target populations is a critical component of the rising costs of care. For structural and historical reasons, drug development is inefficient and poorly integrated across the public and private sectors. We postulate an alternative, integrated model in which governments and industry share the risks and benefits of drug development. The Australian government recently announced support for a AU$185 million innovative multi-stakeholder public-private partnership model for sustainable precision oncology, accelerating biomarker-dependent drug development through integrating clinical trials into the standard of care.

PubMed Disclaimer

Conflict of interest statement

DMT is the CEO of Omico, a non-profit precision oncology program. He has received research support as well as honoraria and speakers bureau from Astra Zeneca, Roche, Pfizer, Novartis, Eisai, Beigene, Seattle Genetics, Janssen, Bayer, Microba, InterVenn, Merck. VT is deputy CEO of Omico. The remaining authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Three stages of drug development in the existing (transaction silo) model vs. proposed collaborative (strategic engagement) model for improving cost-efficiency and sustainability of innovative health care.
Red arrows depict investments; green arrows depict returns; blue arrows indicate exchanges of value; yellow arrows indicate information transfer. Sizes of arrows represent the relative magnitude of monetary value transfer.
Fig. 2
Fig. 2. Genomic screening and cancer treatment in health systems and clinical trial cost-offsets.
©[Leremy Gan] via Canva.com. a: current standard of care treatment; b: clinical trials-based care; c: expanded clinical trials supported by population-level screening.
Fig. 3
Fig. 3. Efficient identification of eligible patients for biomarker-dependent drug trials by population screening.
©[Pixeden] via Canva.com.
Fig. 4
Fig. 4. Increased trial efficiency due to shift from site-based to population screening.
a Screening and trial sites for clinical trials by model. The numbers above each institution represent eligible patients for a biomarker dependent trial. b Differences in efficiency for trial recruitment between models. ©[Visual Generation, Pixeden] via Canva.com.
See this image and copyright information in PMC

References

    1. Wouters OJ, McKee M, Luyten J. Estimated Research and Development Investment Needed to Bring a New Medicine to Market, 2009-2018. JAMA. 2020;323:844–853. doi: 10.1001/jama.2020.1166. - DOI - PMC - PubMed
    1. Garrison LP, et al. Private sector risk-sharing agreements in the United States: trends, barriers, and prospects. Am. J. Manag Care. 2015;21:632–640. - PubMed
    1. Personalized Medicine Coalition. Personalized Medicine at FDA: A Progress & Outlook Report. https://www.personalizedmedicinecoalition.org/Userfiles/PMC-Corporate/fi..., (2018).
    1. Mateo J, et al. Delivering precision oncology to patients with cancer. Nat. Med. 2022;28:658–665. doi: 10.1038/s41591-022-01717-2. - DOI - PubMed
    1. Australian Government Department of Health and Aged Care. The Pharmaceutical Benefits Advisory Committee Guidelines. https://pbac.pbs.gov.au/information/about-the-guidelines.html, (2016).