< PreviousPRECISION MEDICINE20Pharma Business International www.pbiforum.net© Shutterstock /Gio.ttoTailoredtreatment 20-23.qxp_Layout 1 04/10/2018 12:23 Page 1Pharma Business International 21www.pbiforum.netPRECISION MEDICINEThe future of medicine won’t be tailoredtowards an average patient, but to theindividual. This is precision medicine. ThePrecision Medicine Initiative in the USdefines this approach as being “anemerging approach for disease treatmentand prevention that takes into accountindividual variability in genes, environmentand lifestyle for each person”. This is adeparture from diagnosing and treatingpatients with the same approach. In placeof these former models, precision medicineallows doctors and researchers to predictwith a greater level of accuracy whichtreatment and prevention strategies for aparticular disease will work in which groupsof people. This takes much of the guess-work and the trial and error that not onlyadds time to diagnosis and treatment butcan also see patients worsen or evensuccumb to their illnesses. A majorbreakthrough in the United States is set toshake-up the approach to precisionmedicine by decoding, on masse, thehuman genome. When scientists first sequenced the entirehuman genome, it took thirteen years andresulted in an almost $3 billion-dollar pricetag. That was 2003. Now, scientists areplanning to sequence one million genomes. The National Institutes of Health (NIH) isawarding $28.6 million to establish threeAt the opposite end of the scaleof the ‘one size fits all’ model isprecision medicine which ishelping to transform the way inwhich patients are treated. 22 Á20-23.qxp_Layout 1 04/10/2018 12:23 Page 2PRECISION MEDICINE22Pharma Business International www.pbiforum.netgenome centres around the US toaccelerate precision medicine therapies.Falling under NIH’s wider ‘All of UsResearch Programme’, the centres willsequence one million genomes which, itsays, will become a critical component inthe programme’s precision medicineresearch platform. “Fifteen years after the mapping ofthe human genome, this is a pivotalstep toward realising the promise of thathistoric achievement,” says NIH DirectorFrancis S. Collins. “Including high-quality genomic information along withmany other data types collected in theAll of Us program will speed upscientific breakthroughs and ultimatelyimprove the health of futuregenerations.”The genomes themselves will be madeup of participants from all walks of life,including groups that have beenhistorically underrepresented in research.To date, more than 110,000 people haveregistered with the programme to beginthe participant journey, while more than60,000 have completed all elements ofthe core programme. This seesparticipants sharing different types ofinformation be that via surveys or byproviding access to their electronichealth records and blood and urinesamples. As time progresses,20-23.qxp_Layout 1 04/10/2018 12:23 Page 3Pharma Business International 23www.pbiforum.netPRECISION MEDICINE© Shutterstock /Sergei Drozdparticipants will continue to shareinformation through additional surveys aswell as biosamples, fitness trackers andmore. Researchers say that findings fromthis data, when stripped of obviousidentifiers, may lead to more tailoredtreatments and prevention strategies inthe future. Over the coming months, the genomecentres will ramp up operations. As wellas producing genome data forresearchers, the centres will also analysethe data for genetic results to beresponsibly returned to participants whoare interested in receiving them. Initially,these results will include informationabout a set of fifty-nine genes known tobe associated with risk of certaindiseases amenable to prevention ofearlier diagnosis, as defined by theAmerican College of Medical Geneticsand Genomics. The centres will alsoreturn information about drug-geneinteractions that may help inform whatmedications might be best suited forparticular conditions based on thegenetic make-up of participants. In the future, precision medicine willsimply be referred to as medicine. Untilthen, research such as the above arecritical to achieve industry ubiquity andmake precision medicine the defaultsetting for diagnosis and treatment. 20-23.qxp_Layout 1 04/10/2018 12:23 Page 424Pharma Business International www.pbiforum.net26 ÁFINANCETheprice is right There are several channels open to pharmaceutical companies, universities and organisations ro raise capital to fund critical research and developments. The price gouging scandals that haveshocked patients, decimated public faith andpainted big pharma as the enemy, have hadtheir day in court. Many of those on theopposite end of the public’s collective pitchfork justified bumping up their price tags asa means of funding research. The aim, theyargued, was that by increasing costs now,profits could be ploughed back into researchand development, making more effective andaffordable medicines for the future. Butpharmaceutical companies and researchorganisations have several means of raisingcapital to fund research and grease thewheels of innovation. Let’s take the example of cancer clinicaltrials – still one of the leading causes ofdeath in the developed world – and howspecifically they’re funded. In the UK, cancerresearch is funded by drug companies,charities and the government. Often it will bea combination of one or more different typesof funding because running clinical trialsrequires plenty of capital. Research coststhat must be covered, including thetreatments themselves, as well as paying forresearch staff who have to both run the trialand collect the data. The cost continues forstaff and computer technology who have tocollate and analyse the data. Moreover,administrative costs have to be consideredto cover necessary paperwork, datacollection and, of course, production of the24-27.qxp_Layout 1 04/10/2018 12:24 Page 1© Shutterstock /Pixelbliss24-27.qxp_Layout 1 04/10/2018 12:25 Page 2FINANCE26Pharma Business International www.pbiforum.net© Shutterstock /HelloRF Zcoolresults. Then there’s the cost of extratests or hospital stays for patients takingpart. All of these overheads, and that’sno guarantee the trial will yield anyconclusive, useful or positive results. In the above example the moneyrequired for tests and the costs ofhospitals themselves comes from thegovernment. The NHS, meanwhile, frontsthe costs of trials that fall under theNational Institute for Health researchClinical Network’s portfolio of clinicaltrials. If a drug company is running thetrial, however, they have to pay thehospital for the costs of tests and patientstays themselves. In the UK, a significant proportion ofcancer research is funded outright bypharmaceutical companies. These canrange from companies looking to trial,develop and commercialise their owndrugs and treatments. It’s not uncommonfor drug companies to produce a grant orsupply the drug free of charge for trialsrun by other organisations. Collaborationis necessary in furthering ourunderstanding, and often organisationsand companies will work togethertowards a common goal. Sometimes thiscan take the form of an agreement. Charities also have a critical role toplay in funding clinical trials and majoradvancements. In the UK, for example,Cancer Research UK provides the lion’sshare of funds into cancer research. Anassortment of other charities fundresearch into treatment for specificcancers and have collectively inchedforward our understanding of cancer andheralded major breakthroughs intreatment. Simply put, without charitiesraising capital, the cancer researchsphere would be a less innovative space. The Government currently funds healthrelated research through organisationsincluding the Medical Research Counciland the National Institute for HealthResearch. They also help to coordinatecancer research nationally through theNational Cancer Research Institute, all ofwhich help to support key studies andtrials. Running clinical studies, trials andbacking research requires a huge amountof funds to get off the ground. Thereexists a variety of options open to apharmaceutical company to front thecost and help bring a potential newtreatment to market.24-27.qxp_Layout 1 04/10/2018 12:25 Page 3Pharma Business International 27www.pbiforum.netFINANCE© Shutterstock /ADragan24-27.qxp_Layout 1 04/10/2018 12:25 Page 4DIABETES EXPOSÉ28Pharma Business International www.pbiforum.netDiabetes is the term given to thecondition where an individual’s bloodsugar level production becomes too high.It’s categorised into two types, with thefirst being a lifelong condition where thebody’s own immune system attacks anddestroys the cells responsible for insulinproduction. The second is morecommonly related to lifestyle and occurswhen the body doesn’t product enoughinsulin. Diagnoses of diabetes is rapidly risingin tandem, perhaps, with the obesitycrisis and its slew of lifestyle relatedillnesses. In the UK alone, the number ofthose diagnosed with diabetes has risenfrom 1.4 million in 1996 to 3.5 milliontoday. To put that into context, that’s sixper cent of the entire UK population.Taking into account those living withundiagnosed diabetes, this figure is morelikely in excess of four million and rising.By 2025, experts estimate that it will riseto five million. This is more startling still when lookedat in a global context, with an estimated415 million people living with the diseaseworldwide. Forty-six per cent of these goundiagnosed, representing a failure inglobal healthcare systems, poor accessfor patients, and a general lack ofFinding anew solution With the number of people diagnosed with diabetes rising, the need for new treatments and therapies is critical. 30 Á© Shutterstock /Piotr Adamowicz28-31.qxp_Layout 1 04/10/2018 12:25 Page 1© Shutterstock /ratmaner28-31.qxp_Layout 1 04/10/2018 12:25 Page 2Next >