Understanding and addressing patients' health determinants, including their genomic data, is crucial to tailoring care, improving outcomes and reducing costs — and is a key pillar of personalized medicine.
During Becker's 10th Annual CEO + CFO Roundtable, in a session sponsored by Illumina, an applied genomics technology company, Damon Hostin, lead for health systems market access at Illumina, reviewed strategies for advancing the use of personalized medicine and addressed questions from participants.
Three key insights were:
1. The interplay between genomics and other factors is a growing area of focus in healthcare. Human biology is one dimension of human health that contributes to about 20 percent of overall health; other factors related to lifestyle, environmental and social determinants and access to and quality of healthcare make up the rest. The interplay between those factors can advance the overall understanding of population health — for example, by providing genomic insight into predispositions, symptoms and proactive health management. However, integrating the data that makes such understanding possible throughout the continuum of care is still a challenge.
Attesting to the power of genomics to advance personalized medicine and reduce costs, Mr. Hostin said that single-payer health systems globally are already "leaning into genomics as a way of mitigating risk." This choice is facilitated by the fact that in single-payer systems the payer and the beneficiary — from a cost perspective – are the same agent. "Here in the U.S., there's going to be a bit more of a fractionation."
2. There is also an interplay between genomics and therapeutics. Because individual genomics influence the way that drugs are metabolized and the way they impact a disease target, personalized medicine strategies include therapies that interact with a patient's genetic makeup. This approach has applications in treating cancer patients, children with congenital anomalies and intellectual disabilities, patients with rare diseases and, increasingly, patients with cardiovascular diseases.
In addition to being more effective, such therapies allow physicians to give only necessary, "best least amount of care" to their patients, Mr. Hostin explained, alluding to the human and economic costs of overtreatment.
3. Mapping healthcare goals to genomic-enabled strategies can help providers adopt personalized medicine at a much broader scale. As organizations work to align strategic healthcare goals, such as improved outcomes, cost avoidance, patient and physician satisfaction, competitive differentiation, service to vulnerable populations, transformation to value-based care models, more trial enrollment opportunities and ecosystem partnerships, incorporating genetics can bring them closer to achieving these goals.
Genomic-enabled strategies include developing or incorporating:
- Indication centers of excellence
- Clinical translation/ precision medicine programs
- Population/catchment area screenings
- Enterprise data resource for partnering
- Managed population, value-based care and at-risk payment models
- Vertical integration (lab services/pathology)
"The opportunities and the rationale for internalization of genetic sequencing are NOW," said a participant from a 14 hospital non-profit health system in Pennsylvania.
To learn more from Illumina, check out this recent podcast that discusses how genomics informs healthcare.