The UK's Royal Society has published a report on the potential of pharmacogenetics - drug treatments tailored to a person's genetic make-up - following a year-long investigation into the subject. It concludes that although 'personalised medicines' have a promising future, it will be at least another 15-20 years before their use is widespread. The report, entitled 'Personalised medicines: hopes and realities', says this is down to the many gaps in our current understanding of how genetics relates to the causes of disease.
It is hoped that advances in pharmacogenetics will eventually lead to a drop in the number of adverse drug reactions, and an end to the 'trial and error' approach currently used to prescribe medicines. However, some scientists have expressed reservations about whether such technology will ever live up to the hype, what it might cost, and how it would impact on healthcare systems. There are also fears that since drug company profits depend on 'blockbuster' drugs taken by millions of people, it may prove too costly for them to develop a vast array of individually tailored medicines.
Sir David Weatherall, chair of the working group, said: 'Personalised medicines show promise but they have undoubtedly been over-hyped. With the human genome sequenced, some people are expecting personalised medicines within a few years, but the reality is still many years away. There are some examples around today, but the complex multiple causes of diseases mean it will be at least 15 to 20 years before a patient's genetic make-up is a major factor in determining which drugs they are prescribed'.
The report says that the development of personalised medicines is being held up by a lack of knowledge amongst healthcare professionals, and also a shortage of scientists trained to carry out pharmacogenetic research. 'With the NHS expected to spend £11billion on drugs in 2005-6, there is a need to invest in gathering data on how genes influence drug response in the patient population', said Weatherall, adding 'investment needs to come from both the public and private sectors'.
The report highlights the need for financial incentives level to encourage drug companies to work on developing personalised medicines with relatively small potential markets. Sir David also called for pharmaceutical companies to make 'better use' of genetic data collected during clinical trials, and to continue monitoring drugs once they are launched. In addition, further private sector input should come from companies that produce DNA tests, he said.
A report on the ethical and policy issues surrounding pharmacogenetics, published by the Nuffield Trust in 2003, identified reduced availability of some medicines as a potential area of concern. Meanwhile, a report on pharmacogenetics carried out by the Department of Health entitled 'My very own medicine: What must I know?' cautioned that 'media excitement about genetic applications may be exaggerating investment and research activity' in this area.