Personalised medicine: The promise, the hype and the pitfalls

Press Statements
1. Who owns your health data and why?
2. Who really benefits from new cancer treatment development?
3. Does personalised medicine live up to the hype?
4. Does personalised medicine help us to know ourselves?
5. What is the real-life value of precision medicine?

Who owns your health data and why?

‘Public ownership of health data is the most plausible way forward.’

Who owns data about your health: you? The healthcare institution? The funding body? This new study explores the conundrum of personal health data ownership. It considers the interests of all stakeholders and recommends public ownership of health data as the most plausible way forward.

The research highlights several different groups who would claim rightful ownership of the health data, amidst people’s increasing concerns that it is being wrongfully appropriated. However, the development of personalized medicine relies upon the aggregation and analysis of personal health data.

This article recommends and justifies the most plausible model for the ownership of health data and explores the need for recognition of personal interest as well as ownership claims.

Data Sharing and the idea of ownership, Jonathan Montgomery – Professor of Health Care Law at University College London and Chair of the Health Research Authority

* Read the full article online: http://www.tandfonline.com/doi/full/10.1080/20502877.2017.1314893

Video link can been found here: http://www.healthcarevalues.ox.ac.uk/jonathan-montgomery-data-sharing-and-participation

Who really benefits from new cancer treatment development?

‘There is an increasing gulf between high-income and low-middle income countries regarding the affordability of these drugs.’

Unlike other branches of economics, the emotive issue of cancer drugs is intricately associated with socio-political factors, emotional overlay, and public pressure which can lead to industry manipulation.

This new study examines the value added by new cancer drugs being developed in a multi-billion-pound market and the socio-political agenda around them and highlights the increasing gulf between high-income and low-middle income countries regarding the affordability of these drugs.

The authors propose that to achieve a more value-based pathway to drug development, serious changes within the industry need to occur. Examples of such change could be federal authorities taking initiatives in conducting clinical trials and low and middle income countries taking proactive steps in developing and drugs with active properties similar to those that have been previously licensed.

Economics of Cancer Medicines: for whose benefit? Richard Sullivan – Institute of Cancer Policy, King’s College London and KHP Comprehensive Cancer Centre, UK and Bishal Gyawali.

* Read the full article online: http://www.tandfonline.com/doi/full/10.1080/20502877.2017.1314885

Video link can been found here: http://www.healthcarevalues.ox.ac.uk/equity-and-commissioning-richard-sullivan

Does personalised medicine live up to the hype?

‘The current optimism for personalised medicine is distorting clinical consultations, resource allocation and research funding prioritization’

Personalised medicine is widely considered to be the way of the future for medicine. This article examines how the promise and the hype around personalised medicine is changing healthcare.

The study’s author suggests that the current optimism for personalised medicine is distorting clinical consultations, resource allocation and research funding prioritization when in fact most common diseases are caused by a complex interplay of multiple genetic and environmental factors.

The research concludes that clinicians have a key role to play both as innovators and as a firewall against hype, bringing a sober realism into the ongoing debates.

The promise and the hype of 'personalised medicine' Timothy Maughan – Clinical Director of the CRUK/MRC Oxford Institute for Radiation Oncology at the University of Oxford and an Honorary Consultant Clinical Oncologist at the Oxford University Hospital Foundation Trust

* Read the full article online: http://www.tandfonline.com/doi/full/10.1080/20502877.2017.1314886

Video link can been found here: http://www.healthcarevalues.ox.ac.uk/tim-maughan-promise-and-hype-personalised-medicine

Does personalised medicine help us to know ourselves?

‘Stratified medicine offers a newly precise kind of humanising health care through societal solidarity with the riskiest.’

This article examines how and why self-knowledge is important to communication about risk and behaviour change.  It argues that communication about genetic risk between specialists and the public could be improved through deeper engagement with the values, beliefs and cultural commitments of the diverse public.

This research claims that genetic knowledge should not properly be called 'self-knowledge' and so temptations to reduce identity into genomic terms should be resisted. Moreover, any effort to change people's behaviour must engage with cultural self-knowledge, values and beliefs, with genetic risk information acting as a catalyst.

The article concludes that self-knowledge may be found in compassionate communion, made possible through processes of stratification. Stratified medicine thus offers as a newly precise kind of humanising health care through societal solidarity with the riskiest.

Self-knowledge and risk in stratified medicine, Joshua Hordern – Associate Professor of Christian Ethics, Faculty of Theology of Religion, Harris Manchester College, University of Oxford and leader of the Oxford Healthcare Values Partnership (www.healthcarevalues.ox.ac.uk)

* Read the full article online: http://www.tandfonline.com/doi/full/10.1080/20502877.2017.1314889

Video link can been found here: http://www.healthcarevalues.ox.ac.uk/joshua-hordern-personalised-medicine

What is the real-life value of precision medicine?

‘Uncritical adoption of the concept of precision medicine could make healthcare finances even more difficult in every country with those most in need bearing the cost.’

“Precision medicine”, medical care tailored for specific groups of patients using techniques such as genetic profiling, carries huge potential in the treatment of many diseases. However it also raises troubling questions about the use of resources.

In this research it is argued that precision medicine risks concentrating resources on those that already experience greater access to healthcare and power in society, nationally as well as globally. Healthcare payers, clinicians, and patients must all be involved in optimising the potential of precision medicine.

Throughout the article the NHS RightCare Programme is referred to as an example of a national initiative aiming to improve value and equity in the context of NHS England.

It is concluded that, despite great promise, at present precision medicine is potentially low value when applied to complex disease and healthcare payers. Uncritical adoption of the concept of precision medicine could make healthcare finances even more difficult in every country with those most in need bearing the cost. There is, therefore, a need for clear directions for clinicians on how it can be best utilised.

Equity and value in 'precision medicine' Muir Gray – Department of Primary Care, University of Oxford, United Kingdom, Viktor Dombrádi and Tyra Lagerberg

* Read the full article online: http://www.tandfonline.com/doi/full/10.1080/20502877.2017.1314891

Video link can been found here: http://www.healthcarevalues.ox.ac.uk/equity-and-commissioning-muir-gray