The issues of personalized medicine debated in Parliament

Publié le : 5 April 2013

 The Parliamentary Office for Evaluating Scientific and Technological Choices (OPECST), consulted by the Social Affairs Committee, has begun its first hearings on personalized medicine. Alain Claeys and Jean-Sébastien Vialatte, its rapporteurs, will issue a report in autumn 2013 on this medicine which "also poses scientific, economic and ethical challenges."    

The geneticist Axel Kahn defines personalized medicine as, firstly, "the most personalized possible treatment by taking the individual patient into account in his/her totality," and, secondly, as "predicting the effects of medications and forecasting the occurrence of illnesses thanks to genetic tests or the sequencing of the genome." It is also defined as medicine that "categorises individuals according to some of their genetic features.
In oncology, "the pertinence of personalized medicine has been verified for many years" and targeted therapies have been used since the late 1990s. "Personalized medicine is [also] very frequently used with hereditary or orphan diseases, such as sickle-cell anaemia or promyelocytic leukaemia."

However, various questions arise as to how this type of medicine ought to be proposed.
Firstly, the use of personalized medicine obliges the pharmaceutical industry "to reposition itself." The question is to know how these "niche treatments" are to be financed.         
Secondly, data confidentiality, and more precisely the question of whether "patients’ data are sufficiently secure" raises a problem. (Gènéthique press review from 18th to 22nd of march 2013) Prof. André Syrota, president of Inserm, asks: "won’t the national health insurance system or insurance companies bring pressure to bear to know the risks [that people are likely to face]?"            

Lastly, he points out, "in social terms, mass medicine has not reduced the social inequalities in access to health care." The journalist adds: "what will be the situation with personalized medicine? What difference will be made between treatments and comfort?"      
In all cases, "we must stop trying to predict the future." The geneticist Axel Kahn underlines the fact that "knowing a risk, such as tobacco, does not systematically lead people to fight against the occurrence of a disease," for, he explains, "a gene never encodes a destiny: the human being is confronted with an environment.

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