Personalized Medicine

There has been a lot written on how medical care is becoming much more standardized through the use of treatment protocols and drug formularies.  Primary Care Physicians are quick to point out that they are being encouraged, if not forced, to practice medicine in a way that limits individual choices.  Some would say the role of a PCP has become more like a factory worker than an individual artisan.

Most would argue that this standardization of care is good, especially if it is based on evidence based medicine that includes the latest medical thinking and the most recent products approved by FDA.  Some of the concern is that when new drugs or procedures arise it takes a long time for the comparative data to emerge so there is bias towards older therapies.  Oh by the way, this also favors generics and lower priced drugs as well, so there isn’t an economic motivation to make changes.

Gina Kolata’s piece in Sunday’s New York Times where she examines the role genetics has in lung cancer patients is quite interesting.  Without going into the specifics, it is important to note the variations that exist in diseases that are often viewed as one disease. This can now be analyzed based on genetic differences.  This could result in a more targeted patient group in clinical trials and a different way to utilize the drugs once approved.  In other words, the “one size fits all” way of practicing medicine may not always work.

The NYT story talks about genetic work in the Oncology area but it is important to consider whether it might be just as relevant for other diseases.  People are not machines that are all built the same and obviously do not react the same way to different drugs.  Treatment protocols are just the beginning of the story but there is still significant room for treating the individual patient.

The key for the pharmaceutical marketer is to clearly understand the therapeutic environment they must work within.  For most disease areas, generics dominate and they should be recognized as legitimate competition.  Instead of fighting this reality it is important that pharmaceutical brand marketers find the areas where the generics are not working.  Don’t waste your effort saying generics aren’t equivalent to their branded product as this is futile territory.  Concentrate on those areas where a different active ingredient is needed.  This needs to begin with product design, clinical trials, package insert label negotiations and then follow through to the marketing plan.

Price is a critical factor for this effort once a product is on the market.  Lower pricing relative to competition will allow for broader use of the product whereas higher prices may indicate that a company only expects use in a tight niche.   Realistic thinking is critical if marketing strategies are going to have an impact.  To ignore treatment protocols and expect wide usage of expensive therapies without considering economic and clinical realities tarnishes the image of both the company and their products.  If diligent work in this area is not done, potentially useful therapies may go unused even for those patients that need them most.  Different people need different therapeutic options.

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