Personalized Medicine: Worth Its Cost?

Already stretched health care systems face a panoply of challenges, including a high and increasing number of patients with chronic conditions, expensive and rising costs of treatment, and stagnant economies. Not surprisingly, even as specialty pharmaceuticals—or, more broadly, personalized medicine—are touted as the future of medical care because they make more treatments more effective, there are reservations about the value that they offer society as a whole, compared to certain population groups. The findings of Bradford Hirsch and coauthors (Oct 2014) certainly help justify the efficiency and equity concerns of payers and health authorities about the impact of specialty pharmaceuticals. To be sure, we know little about the intended and unintended health, economic, and social impacts of personalized medicine. Advocates claim that personalized medicine provides value for money, as illustrated by the French case of universal molecular testing and targeted treatment of lung cancer patients with epidermal growth factor receptor mutation.1 The sustainability of these benefits, unfortunately, is far from established. Personalized medicine is still both hype and hope. Arguably, the challenge is to produce a preponderance of clear and convincing evidence that specialty pharmaceuticals and personalized medicine are worth their cost.2