The National Institutes of Health (NIH) defines precision medicine as “an emerging approach for disease prevention and treatment that takes into account individual variability in genomics, environment, and lifestyle for each person.”1 Historically, most medical treatments have been designed for the so-called “average patient.” As a result of this one-size-fits-all approach, treatments can be very successful for some but not for others.
Precision medicine gives clinicians tools to better understand the complex mechanisms underlying an individual patient’s health risks, disease or condition, and to better predict which treatments will be most effective.2 It is hoped that this new “golden age” of medicine will lead to improved therapies and interventions to prevent and treat disease in a more efficient and effective way, thereby leading to decreased mortality and morbidity. Indeed, if the promises of precision medicine hold true, there will clearly be a significant impact on the life and living benefits insurance industry.
The Basis of Precision Medicine: Genomics
Genomics is the study of genes, their interactions with each other and the environment, and the resulting phenotype (physical manifestations and biochemical characteristics) of an individual. Genomic medicine is the emerging discipline that involves using genomic information and associated biomarkers to drive clinical care and create molecularly targeted therapies.3 The increased speed and decreased cost of gene sequencing over the last 15 years have resulted in larger and more refined databases from which personalized clinical applications can now be developed.
Understanding the enormous complexity of genomics requires multidisciplinary cooperation from both the government and private sectors. Not only is advanced high-throughput DNA sequencing necessary, but major developments in bioinformatics, cloud-based processing technologies and machine learning will be needed to analyze huge data sets to unlock the secrets of the genome.
Genomics has led to a growing number of clinical applications, including pre-disease risk assessment (and mitigation), refined disease diagnosis and prognostication, and the design of individualized treatment protocols. From an underwriting point of view, the impact of genomics cannot be understated, and from a medical point of view, is not even close to being fully realized. While essentially every branch of medical science has already been affected by genomic medicine, the primary areas where it is currently having its most visible impact are in the developing field of pharmacogenomics and the diagnosis and treatment of cancer.
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