As published in the summer issue of Minnesota Physician, Kevin Halling, M.D., Ph.D., Co-Director of the Genomics Laboratory, recently participated in the 47th session of the Minnesota Health Care Roundtable. The topic was, “Precision Medicine: A New Approach to Care.”
The roundtable, moderated by Minnesota Physician Publisher Mike Starnes, covered such topics as defining precision medicine, examples of individualized medicine within health care, challenges of incorporating precision medicine into clinics, advances, genetic counselors, consumer protection, and reimbursement issues.
The panel of seven experts included Dr. Halling; Ginny Adams, R.N., a senior risk consultant at Coverys; Josiah Allen, director of medical affairs at OneOme; David Brown, M.D., vice president of biomedicine at Recombinetics; Nancy Mendelsohn, M.D., director of medical genetics at Children’s Minnesota; Alan Spiro, M.D., senior vice president and chief medical officer at Medica; and Melissa Truelson, CGC, a certified genetic counselor at Ambry Genetics.
Dr. Halling added insightful commentary on the panel when discussing the economics of individualized medicine, stating, “A lot of our testing presents an opportunity to avoid giving expensive drugs to patients who will not benefit from them, especially in cases involving immunotherapies and some targeted therapies.”
Many echoed his sentiments with Mr. Allen adding, “We are going to have to think very strategically about how to implement this in a cost-effective manner and also to ensure that we help people avoid adverse events.”
When the subject came up about some of the biggest challenges the industry faces, Dr. Halling answered, “Consider the terms clinical validity and clinical utility. You could have a sound test . . . but when you use it in practice, it may or may not change patient management, so it is a waste of money. For genetic tests, they want to see evidence not only of analytic validity, but also of clinical validity and clinical utility.”
When asked about patient’s involvement and ethical issues surrounding precision medicine, Ms. Adams responded, “We need to raise awareness of what is available, as well as its limitations . . . . Genetics is not deterministic; it is one piece . . . along with lifestyle choices and your environment.” In response to patient privacy, Dr. Spiro said, “Even though we’ve eliminated most of the medical underwriting, there is still a risk of using data like this to exclude people from services.”
Dr. Halling added, “New discoveries are coming out at such a rapid pace, and it is very exciting, from a scientific point of view . . . . But there obviously are a lot of economic and ethical dilemmas that we will have to deal with over the coming decades.”
The complete transcript can be viewed on pages 20–28 in the publication. The article ends with Dr. Brown stating, “We’re going to make medicine great again.”