Personalized Medicine in the Aftermath of COVID-19
by Edward Abrahams
In the aftermath of the COVID-19 pandemic, policymakers and citizens will increasingly turn to thought leaders in health and medicine for answers about how to equip our health systems to respond to medical challenges in a new era. Proponents for personalized medicine are well-positioned to contribute to these discussions.
Humanity’s historic struggle with the novel coronavirus has fostered a new appreciation of science, technology, and the principles of personalized medicine.
The widespread adoption of social distancing measures that shut down the economies of entire nations has added another layer of significance to conversations about the value of diagnostic tools that could have helped target prevention strategies to the most at-risk populations without subjecting everyone to devastating social and financial consequences — something that personalized medicine has long promised to do. And thanks to the efforts of several of the field’s most prominent thought leaders, it will be hard for decision-makers to overlook this new imperative to adopt diagnostic testing that can underpin more precise medical interventions.
In an opinion piece published on March 28 in The Timmerman Report titled “Knowledge is Power: Don’t Give Up on Diagnostic Tests for COVID-19,” Personalized Medicine Coalition (PMC) Board Member Michael Pellini, M.D., Managing Partner, Section 32, points out that following “a decade of breathtaking progress” in science and technology, citizens in every corner of the country were forced into their homes to avoid SARS-CoV-2.1 He attributes this catastrophe to a failure to adopt a national testing strategy early on, calling it “malpractice at the national level.”
Pellini’s contentions about the need for more diagnostic testing were echoed by many others, including former Food and Drug Administration commissioner Scott Gottlieb, M.D., and Lauren Silvis, who served as Gottlieb’s chief of staff at FDA before becoming a Senior Vice President at Tempus, a “data-driven precision medicine” company. In an op-ed for The Wall Street Journal on March 29 titled “The Road Back to Normal: More, Better Testing,” Gottlieb and Silvis called on Congressional leaders to fund a “sentinel surveillance system” that “allows cases to be identified and tracked in real time without overburdening providers with data entry and case reports.”2
This collective realization of the importance of diagnostic testing and more sophisticated data analysis bodes well for personalized medicine, which promises to deliver value by linking therapeutic decision-making to the use of molecular diagnostic tests.
The widely variable effects of the new virus in patient populations with similar characteristics has also inspired additional research about the molecular factors that contribute to disease progression in each individual patient. This, too, promises to improve the outlook for personalized medicine.
In an article published in The New Yorker for March 26, Siddhartha Mukherjee, M.D., D.Phil., of Columbia University reviews the medical evidence suggesting that the amount of a virus a person is exposed to as well as the amount of the virus the person sheds after infection may be strong predictors of an individual patient’s disease severity or contagiousness.3 And the propensity of the SARS-CoV-2 virus to cause unpredictably severe illness in some patients with no obvious risk factors like age, diabetes, or a weakened immune system has prompted researchers around the world to begin searching for genetic characteristics that may influence how easily the virus can penetrate a patient’s respiratory cells.4 These studies are opening new frontiers for personalized medicine.
But perhaps the most promising development for the field, at least in the United States, is the emergence of a Congressional Personalized Medicine Caucus that is committed to addressing outstanding issues in areas such as regulation and reimbursement.5
During an educational briefing PMC co-hosted on February 26 alongside the caucus co-chairs, who include Sens. Tim Scott (R-SC) and Kyrsten Sinema (D-AZ) and Reps. Eric Swalwell (D-CA) and Tom Emmer (R-MN), Swalwell said American families are “counting on us to make [reimbursement policies] right.” And Emmer called on policymakers to “define the regulatory process to ensure that innovation isn’t stalled.”
As we consider the future of health care in this evolving landscape, the opportunity of personalized medicine is ours to seize.
- Pellini, M. (2020, March 28). “Knowledge is Power: Don’t Give Up on Diagnostic Tests for COVID-19.” The Timmerman Report. Retrieved from https://timmermanreport.com/2020/03/knowledge-is-power-dont-give-up-on-diagnostic-tests-for-covid19/.
- Gottlieb, S., Silvis, L. (2020, March 29). “The Road Back to Normal: More, Better Testing.” The Wall Street Journal. Retrieved from https://www.wsj.com/articles/the-road-back-to-normal-more-better-testing-11585503340.
- Mukherjee, S. (2020, March 26). “How Does the Coronavirus Behave Inside a Patient?” The New Yorker. Retrieved from https://www.newyorker.com/magazine/2020/04/06/how-does-the-coronavirus-behave-inside-a-patient.
- Kaiser, J. (2020, March 27). “How Sick Will the Coronavirus Make You? The Answer May Be in Your Genes.” Science. Retrieved from https://www.sciencemag.org/news/2020/03/how-sick-will-coronavirus-make-you-answer-may-be-your-genes.
- Bens, C. (2020, April 2). “Policymakers Improve Outlook for Personalized Medicine in US With Attention to Educational, Regulatory, Reimbursement Priorities.” Personalized Medicine in Brief (Vol. 14). Retrieved from http://www.personalizedmedicinecoalition.org/Userfiles/PMC-Corporate/file/PM_in_Brief_Vol_14.pdf.
Edward Abrahams is president of the Personalized Medicine Coalition, a nonprofit education and advocacy organization in Washington, DC.