It seems that a day barely passes without the promise of genetic medicine being promoted. All this promotion has the effect of making me sceptical.
I wondered if I was just being cynical. Then I realised I had a friend who I could ask. My friend is David Wyatt who started one of the early bio-tech companies in Australia. Since then he has been involved in lecturing at university and various other start up ventures. David is fairly ‘green’ in his approach to life. He has been a candidate for the Australian Greens and also has a quite ecological understanding of life in general. In short he is knowledgeable but not just a booster for the industry. David is of course a very busy person. I sent an email asking him what his thoughts on the promise of genetic medicine were and he kindly replied with this email. I hope you find it informative.
I’m really stretched for time (& will be for a few months I expect) so I’ll quickly kick off some thoughts on this. It is an interesting question.
Human Genomics is a relatively new field that evolved out of the human genome project (HUGO). The idea of individualized therapy matched to an individuals genes is called pharmacogenomics.
The computational demands of the genetic analysis is so great that it resulted in an alliance between the IT industry and genomics and really stretched the IT industry….supercomputers etc. I was hired as a consultant by the Aus Govt a few years back to facilitate a joint biotech Science project between Australia and France. When I visited France I was struck by the extent that the big national genomics centers were dominated by computers. I became involved in similar bioinformatics projects in Australia.
I’m no longer up to date on this fast moving field and am a little skeptical.
The very nature of Big Pharma/capitalism will tend to ensure that these developments are only available to wealthy people. Unless there are major technological breakthroughs (which are possible), the cost of individualizing treatment genomically is likely to be very high initially. In theory, pharmacogenomics is meant to ensure that a therapy (usually drug) works well without any side effects and hence there would be no need to perform the large scale clinical trials. Clinical trials on large populations often fail as drugs work well on some individuals while causing major side effects on others. This could well have a genetic basis.
Already many old drugs that failed clinical trials have been resurrected and are being looked at again under pharmacogenomics.
As is often the case, initial promise of pharmacogenomics seems disappointing and may take a long time.
If the combination of genomics, IT and pharmacology is as powerful as hoped, it might be possible for the cost of such individual treatment to drop sharply over time. Initially only the wealthy would be treated and the diffusion to the masses uncertain. Without mass markets it might not even be affordable/viable for the wealthy.
If you have any thoughts on genetic medicine please let me know in the comments. Favourable, against and all points in between are welcome.