Personalized Medicine and The Pharmacist

Do you think pharmacists should be doing personalized medicine?

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As the techniques of isolating and analyzing genetic information are getting more advanced and mature, personalized medicine has become possible and is going to emerge as one of the most effective and safest approach to treat diseases in the future. Since every individual has a exclusive set of genetic makeup, the phenotype of  each person is unique and hence how a person responds to a drug is going to be different from others.  For example, different people have various degrees of drug metabolism. Some might metabolize a particular drug faster while others might be slower. The different rate of metabolism will lead to different drug responses in a population. Unfortunately,  traditional drugs can only target patients with responses within a certain reference range.  What about the ones that are falling onto the high and low ends? This will lead to adverse drug reactions to these individuals. To tackle this problem, personalized medicine can be made using genetic sequencing and analysis from each individuals. By identifying specific genes and level of protein expression,  each tablet or capsule that is dispensed to the patient is going to “tailor-made” (drug ingredients and dosage) in order to offer the most effective and safest treatment for every single patient.

However, to this stage, the primary drawback of personalized medicine is the cost. Genotyping tests requires resources, lab technicians and time. Considering our population is aging over time and in few decades, majority of that will be in the older age group which usually most cost would go into. This will definitely add more burden to our health care expense . In a long run, the cost of genotype analysis process has to be reduced in order to make personalized medicine to be feasible and popularize in the general public.

It is my humble opinion that the transition from the current mode of operation to one more geared towards personalized medicine is an inevitable yet difficult process.

Whether we like it or not, personalized medicine is already an integral part of the health care system. In fact, personalized medicine is in effect from conception all the way until death. As fetuses and embryos, pre-formed humans are already screened for genetic defects that may be included in the parents’ genome. During life, people are considered to be more at risk for certain illnesses on the basis of age, race, sex, living conditions, life style, and family history. The patient’s medical history is documented throughout his course of life, and also used to provide details regarding the patient’s health status. There is a growing trend of medicine geared towards the individual, and it is only going to expand as society pushes forward. As a major component of the health care system, it is only natural for pharmacists to be part of this increasing trend.

The inevitability of the pharmacists’ involvement in personalized medicine can be observed from the following reasons. First, as greater advances in technology are made, it is becoming easier to build genetic profiles for individuals. This, in effect, leads to the acquisition of more genetic data. The data can contribute to trends, and the trends can be used to predict illness. As the distributor of medication to fight illness, pharmacists will no doubt have to be familiar with such systems. Second, there is a gradual shift in the health field from dealing with acute conditions, to dealing with chronic illnesses. Going hand in hand with chronic illnesses is increased refills for prescriptions, resulting in increased contact and the building of patient relationships. As the pharmacist knows more about the patient with each interaction, it is only logical that his recommendations become directed at the patient’s particular situation. Third, with the introduction of regulated technicians, pharmacist will have to revaluate their role in the health care team. As dispensing duties are gradually being shifted to technicians, utilizing the pharmacist’s knowledge in delivering effective drug therapies will become increasingly important. Personalized medicine will become a very important facet of the new role of pharmacists.

However, despite the inevitability, the transitional process would likely be a long if not difficult one. As with most pharmacies, the pharmacist does not only play the part of a health professional, but also the part of a revenue generator. Revenue often comes from processing prescriptions fast, and doing things fast means less time for patient interaction. This can become a problem for personalized medicine in that unlike doctors, patients do not make appointments to see the pharmacist. Patients would rather like to get their prescriptions fast, instead of wait while the pharmacist tries to make the regimen “personalized” for the previous patient. This also ties into the next point of public image. To many members of the public, pharmacists are still not regarded in the same light as doctors. This means that as personalized medicine become more prevalent, patients would rather go to their doctors for the service instead of pharmacists. This problem would be compounded if doctors also felt the same way, and would rather not give up their piece of income to pharmacists. This leads into the last point of reimbursement. For the service to be conducted, some sort of fair reimbursement system must be set up. If the reimbursement is too low, pharmacies will not likely spend the time needed to conduct personalized medicine. If the reimbursement is too high, other health professionals will complain of unequal treatment. A delicate balance of all these issues described above and more must be achieved, before the pharmacy profession is ready to move on to delivering personalized medicine.

Let us know what you think.

Kevin Tai, Yi (David) Sun

Group 12

Written by ksltai

February 1st, 2012 at 9:04 pm

Posted in Uncategorized

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