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Radio Review: Personalised Medicine – Dose by Design

19 September 2016
Appeared in BioNews 869

Personalised Medicine – Dose by Design

BBC Radio 4, Sunday 21 August

Presented by Vivienne Parry


Personalised Medicine. A promise of medical treatment tailored to the individual. A promise that has been decades in the delivery. But now, as such treatment appears to be within reach, will the dream be dashed by bureaucracy, inertia and funding crises?

Vivienne Parry explores these questions and more during a half-hour examination of the progress made by the NHS in delivering fully integrated personalised medicine.

The programme starts with a series of soundbites that outline the scale of the problem in implementing personalised medicine, and also the potential opportunities.

This grand scale is brought down to a more human size with the story of Jack – a baby born with seemingly uncontrollable diabetes. Defying conventional wisdom, insulin was not helping with Jack's diabetes, but by analysing Jack's genome they were able to find out and correct the problem. The programme makes a convincing argument that Jack would not be alive today were it not for personalised medicine.

Parry asks searching questions throughout: Will early costs forever prevent the NHS from reaping the benefits – and savings – offered by personalised medicine? Is the only outcome 'very expensive medicines for the privileged few'? Why aren't we systematically using genome screening for genetic diseases? I found it increasingly difficult to find an argument against this. I was astounded by news of a handheld gene scanner that can be used at a hospital bedside. Future medicine seems to be here, if only we could routinely commission it.

Yet, although this programme was packed with surprising facts and is definitely worth listening to, it would have been improved with more depth in places. Ethical issues were entirely ignored – instead the focus was on structural problems in delivering personalised medicine. The programme makes a blanket assumption that personalised medicine is a universally good thing. For example, when it was suggested our grandchildren may be genetically screened from birth, the ethical element was ignored while the problems around the handling and security of such large volumes of data were examined.

Parry certainly makes a solid case for the benefits of personalised medicine. However, I was left confused by the purpose of the programme. The interviewees were convinced that we would see personalised medicine delivered throughout the NHS within a decade, with one expert dubbing personalised medicine as 'the new normal'.

With the consensus seemingly firmly in favour of the NHS being able to deliver personalised medicine, I feel the programme could have looked in more detail at how 'current uncertainty' might derail this. Unfortunately, this question was posed just minutes before the end of the programme. Personally I found Parry's 'I think it is important that it shouldn't' an unsatisfactory answer.

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