The promise of precision medicine

Delivery barriers

Precision medicine holds huge potential, but we still have a long way to go before we’ll see it integrated into healthcare around the world.

One of the challenges that needs to be tackled as a priority is proving the value of precision medicine. It has the potential to be more cost- effective in the long term. Treating people when they are unwell is expensive – and with an ageing population at hand, future healthcare systems are likely to be put under even more pressure.

The preventative approach to well-being that is promoted through precision medicine offers people the promise of not only living longer, but also living a healthier life.

However, the value of precision medicine is still too often implicit, and we need clinicians and the scientific community to produce hard evidence that it is cost-effective. This will be central to swaying sceptics and encouraging governments and healthcare organisations to invest in implementing precision medicine at scale.

If we are able to overcome this first hurdle, we must also address a skills shortage. Currently, we do not have enough clinical geneticists, genetics counsellors or pharmacists who are versed in genomic data usage to integrate precision medicine fully into healthcare systems.

A significant effort will be required from health industry bodies, governments and medical schools to train workers so that they can perform the tasks that will be needed to fully exploit the use of precision medicine.

At Hamad Bin Khalifa University in Doha, Qatar, this task is already in hand. The New College of Life Sciences focuses mainly on educating the next generation of healthcare professionals in precision medicine and preventative interventions. We hope to have trained around 700 precision medicine professionals within the next five years.

COVID-19 has taught medical professionals around the world the importance of translating research into patient well-being – quickly and efficiently. This is especially important in precision medicine, where research and understanding are constantly evolving.

Our hope is that more recently qualified doctors and clinician scientists, who have a clearer focus on the latest developments, will help spearhead the transition of innovative research into applicable medical outcomes.

There are also significant data and technology issues that we need to overcome. We have already captured vast amounts of genomic data. The issue is that this data was most often collected as part of siloed projects and isn’t fully accessible and usable at scale.

Health systems will need to work with technology companies to find the best solutions for gathering the disparate information already captured and turning it into user-friendly tools that clinicians can use on a day-to-day basis.

Due to the vast amounts of data required, AI is expected to play a major role in this. It is also absolutely crucial that this data is fully secured.

New fields of research

If we can overcome the barriers to implementing precision medicine, it has the potential to shape lives in many ways. Teams around the world are conducting research in various relevant disease areas.

In Qatar, research into genomics and precision medicine is being used to tackle diseases such as obesity, diabetes and cardiovascular disease. Diabetes is a particularly complex disease, which involves more than one gene type, and is therefore an area where the use of personalised medicine could help healthcare professionals diagnose more targeted treatment.

The world- class Sidra Medicine hospital and the Qatar Biomedical Research Institute are using genomes to identify personalised lifestyle interventions to tackle obesity. This could have an especially positive impact in paediatric obesity, where early intervention can improve outcomes.

Another fertile area of research is the application of precision medicine to Autism Spectrum Disorders (ASD). There is currently no effective medical treatment for ASD, however, Qatar Biomedical Research Institute’s Neurological Group has been surveying the genomes of individuals with autism and their family members to identify potential targeted treatments.

The future of pharma

Drug metabolism rates vary between patients. Some patients metabolise a drug so rapidly that therapeutically effective blood and tissue concentrations are not reached; in others, metabolism may be so slow that usual doses have toxic effects.

Individual drug metabolism rates are influenced by genetic factors, which means that if clinicians have a better understanding of a patient’s genetic make-up, they could prescribe the right amount of the right drug treatment for the individual.

This not only gives patients the confidence that they are receiving the most effective level of care, but could also save the healthcare system money through more specific and effective care in the long term.

A new initiative that looks specifically at this area – which is known as pharmacogenomics – based on how genomics can be used to optimise drug selection and usage, is currently being developed in Qatar.

Meanwhile, clinicians in the United States have been increasingly using genomic insights to inform their decisions on prescriptions. We will hopefully see this becoming more widespread there and elsewhere around the world as the relevant infrastructure is put in place.

Getting it right

We are on the cusp of a new era when it comes to medicine. The broader integration of precision medicine into healthcare beyond specific genomic applications will happen, but it will require a supporting infrastructure, the right skills, investment – and most importantly – buy-in from patients and stakeholders.

We are still in the early stages, but the future offers great promise.