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Precision, preventive medicine innovations provide best care value

Preventative, personalized, precision medicine innovations have the potential to produce huge societal benefits, but the motivation to develop them is lacking, according to a recently published viewpoint in The Lancet.

“Preventive, personalized, and precision medicine interventions targeted at reducing heart disease would have the greatest societal benefit, because heart disease is very common, and has a relatively large effect on life expectancy. Other diseases such as stroke or lung disease are much less prevalent and odder smaller opportunities for creating additional years of healthy life from incidence reduction,” Victor J. Dzau, MD, of the Institute of Medicine in Washington, D.C., and colleagues said in a press release.

Researchers used the Health Economics Medical Innovation Simulation, a preexisting health simulation model, to assess the benefits and cost of personalized precision medicine (PPM) innovations that would potentially improve identification and screening of presymptomic, high risk patients. Dzau and colleagues analyzed preventative interventions aimed toward reducing cancer, diabetes, heart disease, stroke, lung disease and hypertension by a set percentage, beginning in 2012. Interventions needed to be sustainable throughout a lifetime.

The analysis, which calculated health generated value from 2012 to 2060, revealed that even a 10% reduction in one of the six diseases could potentially garner between $33 to $114 billion, in the form of longer and healthier lives. Heart disease PPM innovations appeared to have the greatest value, due to the disease’s high occurrence and influence on life expectancy. The researchers noted that the value in developing these innovations is greatly tied to the prevalence of a specific disease.

Treating patients who are already sick is the priority in the U.S., rather than preventive innovations, according to the researchers.  They hypothesized that this could be due to the current ‘reimbursement environment’ in the U.S. which favors quick profits, rather than long-term investments and since compensation for testing is based on cost, instead of value.

“In the U.S.A., private insurers’ incentives favor interventions with immediate benefits and short payback periods. But the real benefits of [personalized and precision medicine] innovations accumulate over a much longer time, as individuals enjoy living longer in good health. Our predictions show that developing a model that generates positive returns for private payers could benefit everyone,” Dzau said in a press release. – by Casey Hower

Disclosure: Dzau reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.