Healthcare Genomics

Ever since the beginning of the Human Genome Project (HGP) in 1989, the talk of revolutionary changes it could unleash on medicine and healthcare as a whole began. However, for a while it appeared to be a mere mirage and science seemed to enrich science without ever leading to delivery of any useful products or services affecting human life. That is now beginning to change. The lab-to-market place transition seems to have begun.

The whole healthcare continuum is likely to be influenced by the progress in genomic science. The healthcare markets are witnessing launch of genetic tests, personalised medicines, therapies, which in turn are influencing the clinical care and patient outcomes. Genetic tests seek to identify an individual’s predisposition to a disease, given the genetic makeup and hence susceptibility to disease, enabling the physicians to customise the precise treatment option that is right for that individual. This changes the healthcare paradigm into preventive care as opposed to the existing eventbased, reactive healthcare.

Tests that are already available in this category include BRACAnalysis from Myriad Genetics, a genetic test for hereditary breast and ovarian cancer and HIVmirror which tests people for a gene that can slow the progress of HIV.

The FDA too has taken cognizance of this potential of genomics to revolutionise healthcare. It has issued elaborate guidelines for data submissions, organises events and publishes new considerations and findings regularly.

Personalised medicine is another offshoot of progress in genomics. It is based on the premise that each individual is unique in terms of genetic makeup and use of traditional one-size-fits-all drugs has limited results in some cases and adverse patient outcomes in others. The products that emerged in this area include ImClone Systems Incorporated's Erbitux for Cancer and Genentech's Raptiva for Plaque Psoriasis.

Against this backdrop, this issue presents a collection of articles and interviews focused on this topic. The articles talk about how personalised medicine can transform the treatment of Cancer and Cardiovascular diseases. The three interviews give unique perspectives on the potential, challenges of genetic testing. The cover story also presents a perspective on the convergence in the life sciences industry and how it can improve care. This convergence is also most likely to be influenced by genomics in the future.

However, it is still early days. Formidable challenges lie ahead for the full potential of genomics to emerge in the healthcare arena. The significant ones among these are limited understanding of the interplay of genes as well as effect of other aspects such as lifestyle, confidentiality, and ethical dilemmas.