10,012 research outputs found

    It's All About Me

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    The growth of personalised medicine threatens the communal approach that has brought our biggest health gains

    Personalised medicine: a critique on the future of health care

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    In recent years we have seen the emergence of “personalised medicine.” This development can be seen as the logical product of reductionism in medical science in which disease is increasingly understood in molecular terms. Personalised medicine has flourished as a consequence of the application of neoliberal principles to health care, whereby a commercial and social need for personalised medicine has been created. More specifically, personalised medicine benefits from the ongoing commercialisation of the body and of genetic knowledge, the idea that health is defined by genetics, and the emphasis the state places on individual citizens as being “responsible for” their own health. In this paper I critique the emergence of personalised medicine by examining the ways in which it has already impacted upon health and health care delivery. Keywords Personalised medicine; Health care; Neoliberalism; Ontology; Epistemology; Ethic

    Personalised medicine, unmet need or business strategy?

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    Personalised medicine is a discipline that integrates pharmaceutical development with existing knowledge about the genetic and phenotypic factors that influence drug response. This integration enables tailoring therapies to individual patient’s characteristics to help improve their safety and efficacy. Personalised medicine implies a shift in the way drugs are delivered as it requires new forms of testing that assess the patient´s eligibility for a drug. This poses new challenges, both at a regulatory and reimbursement level. Personalised medicine has reached higher commercial success and clinical uptake in drugs under development than old and off-patent drugs. This paper uses the case of TPMT testing to illustrate the reasons why personalised medicine for off-patent drugs is less used at a clinical level than personalised medicine for drugs under development.<br

    Personalised medicine: Priority setting and opportunity costs in European public health care systems

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    “Personalised medicine” is currently attracting considerable attention and raising high hopes and expectations in modern medicine. The term “personalised medicine” denotes the use of genetic or other biomarker information, and it does not focus on a more personal patient-doctor relationship. Furthermore, personalised medicine is associated with ethical problems like priority setting and opportunity costs in solidarity-based public health care systems. Personalised medicine provides modern, highly specific and expensive diagnostics and treatments, which serve only limited subgroups of patients. At the same time, research in other fields of clinical medicine, which could be of benefit to more patients than such limited subgroups, remain underfunded

    Personalised medicine: Priority setting and opportunity costs in European public health care systems

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    “Personalised medicine” is currently attracting considerable attention and raising high hopes and expectations in modern medicine. The term “personalised medicine” denotes the use of genetic or other biomarker information, and it does not focus on a more personal patient-doctor relationship. Furthermore, personalised medicine is associated with ethical problems like priority setting and opportunity costs in solidarity-based public health care systems. Personalised medicine provides modern, highly specific and expensive diagnostics and treatments, which serve only limited subgroups of patients. At the same time, research in other fields of clinical medicine, which could be of benefit to more patients than such limited subgroups, remain underfunded

    Sustainability of personalised medicine

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    Per aconseguir l'equilibri econòmic, hi ha una equació molt bàsica que diu que els ingressos han de superar les despeses. Tot i que la crisi financera ha fet que la despesa en sanitat hagi caigut dràsticament des de l'any 2010, el consum públic dels recursos d'assistència sanitària continua creixent. L'única manera d'aconseguir l'equilibri és que la despesa en nous recursos quedi compensada per guanys futurs. Pot satisfer la medicina personalitzada aquesta necessitat? De moment, hi ha poques evidències que facin pensar que la medicina personalitzada reduirà els costos sanitaris pel fet de reduir els costos dels medicaments. En un escenari de medicina personalitzada per als propers anys, els ingressos seran, en el millor dels casos, neutres, mentre que les despeses per al diagnòstic i la prevenció augmentaran i el tractament tindrà, com a molt, un efecte neutral.To achieve sustainability, there is a very basic equation that says that income has to be equal to or greater than expenditure. Despite the financial crisis, that lead expenditure in healthcare to fall sharply since 2010, consumption of healthcare resources continues to grow. The only way to achieve equilibrium is for expenditure on new resources to be balanced by future gains. But can personalised medicine meet this need? At the moment, there is little reason to think that personalised medicine will reduce healthcare costs by reducing drug costs. In a personalised medicine scenario, income will, at best, most likely be neutral in the coming years whereas expenditures for diagnostics and prevention will increase and treatment will, at best, have a neutral effect

    Responsible personalised medicine: Exploring the ethical, legal, social, political and economic issues of manufacturing, distribution, access and reimbursement. A Report of the Responsible Personalised Medicine Project, UCL Future Targeted Manufacturing in Healthcare Hub

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    This report provides an overview of the ethical, legal, social, political and economic (ELSPE) issues underpinning the “manufacturing, business and regulatory challenges” that confront the development and delivery of affordable and accessible new targeted biological medicines. We specifically focus on the evolving definitions and its implication for the public understanding of personalised medicine (section 1), issues of manufacturing and distribution of Personalised Therapies (section 2) and institutional readiness (section 3) specifically focusing on emerging regulatory and reimbursement pathways (section 3.2) and how these are shaping or being shaped by ‘real world evidence’ (section 3.3). This is followed by our reflection on the implications of and for the entangled, complex and contingent interrelationships between personalised medicine, society and responsibility (section 4). Finally we conclude with discussion of the gaps and priorities for future ELSPE research on manufacturing of advanced biotherapeutics in terms of access, reimbursement, skills and infrastructure, regulation, responsible research and innovation (RRI) and the international political economy of emerging personalised medicine markets (section 5). This is a necessarily narrower review of the spectrum of ELSPE issues that attend personalised medicine activities and reflects this report’s aims to focus on those aspects of personalised medicine addressed by the UCL’s Future Targeted Manufacturing in Healthcare Hub

    Understanding pharmacogenomic testing and its role in medicine prescribing

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    When making prescribing decisions, it is important for healthcare professionals to remember that individual patients may respond differently to medicines. For example, some patients may experience a therapeutic benefit while others may experience an adverse drug reaction. The aim of personalised medicine is to tailor treatment based not only on a patient's clinical factors, but also on their genetic profile. Pharmacogenomics is a branch of personalised medicine that is concerned with how differences in people's genomes affect their response to medicines. Pharmacogenomic testing, which recently has become less expensive and increasingly available, can inform nurses' prescribing decisions and improve patient outcomes. This article discusses personalised medicine and pharmacogenomics, including how pharmacogenomic testing can optimise medicine prescribing, and explains the role of nurses in the process
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