What does genetic screening mean for the drug industry?
My friend Lexi sent me a link to a NYT article that discusses personalized medicine (also known as pharmacogenomics), which is an area of great interest to me. It’s what I focused on in my master’s work, and it’s an area that, given the right opportunity, I intend to start a biotech in one day.
The article describes the promise of personalized medicine reasonably well: The opportunity to select the best therapy for a patient based on his or her genetic profile. Dr. Friedman correctly notes the opportunity for improvements in patient outcomes in terms of drug efficacy and safety, with a special eye towards his own specialty of psychology. He goes astray, however, at the very end:
Aside from the potential to transform clinical psychiatric practice, these new developments will surely change the relationship between doctors and the drug industry and between the industry and the public. Direct-to-consumer advertising will become nearly irrelevant because the drugs will no longer be interchangeable, but will be prescribed based on an individual’s biological profile. Likewise, doctors will have little reason to meet with drug company representatives because they won’t be able to give doctors the single most important piece of information: which drug for which patient. For that doctors will need a genetic test, not a salesman.
I find several things wrong with this paragraph.
Although doctors may find it challenging to select the right treatment for a condition (especially depression!), the available therapies are hardly interchangeable, even today. That’s one of the most important reasons why clinical trials exist: to demonstrate clinical attributes that differentiate a given drug from other existing therapies. Also, Dr. Friedman assumes that the genetic screens will always produce extremely clear results — but what if they don’t? Or what if the screens can only point to a set of therapies — what then? Those are critical situations in which reps will be able to consult physicians on the remaining differentiating attributes.
Furthermore, reimbursement education (for both the genetic screen and for the drug itself) is also a major function of most reps. Many doctors and caregivers struggle to understand whether or not a patient can afford a therapy, especially if the patient is on Medicare. Drug companies, including Amgen and many others, often step up to help educate physicians and guide patients to the form of coverage that best allows the physician to treat in the manner they see fit. That role will become even more critical with a screen to pay for on top of the therapy.
Finally, I don’t see personalized medicine making direct-to-consumer advertising irrelevant. If anything, marketers would focus even more on getting patients into the office to get the test, thus feeding the genetic screen funnel.
What about you? What do you think genetic screening will mean for the pharmaceutical and biotech industries?
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