The Ontario Personalized Medicine Network (OPMN) is led by an expert panel to assess the challenges and opportunities presented by personalized medicine. The objective of the OPMN is to ensure Ontario is well positioned to capitalize on the exciting and transformative technology revolutionizing the medical care landscape. Membership in the OPMN is voluntary: sign up here.
The purpose of the OPMN is to help identify critical paths to enabling Personalized Medicine in Ontario. With the support of both the Ontario Ministry of Health and Long Term Care and the Ministry of Research, Innovation and Science, the OPMN is mandated to align existing resources and efforts to maximize the impact of personalized medicine in Ontario.
What is Personalized Medicine?
Personalized medicine is an approach to health care in which decisions are tailored to the individual using genetic information, and treatment is informed by a deep understanding of the genomic and molecular changes that contribute to the disease. The concept of personalized medicine is embodied by the expression “the right medicine to the right person, at the right dose and at the right time.”
Personalized medicine presents an incredible opportunity to revolutionize health care in Ontario and around the world. Genomics and related fields have improved our understanding of the human body and the relationships between genes, proteins and disease. Personalized medicine builds upon this knowledge and capability to provide more effective health care through improved:
- Prevention– assessing disease risk and taking action to prevent or delay onset and symptoms
- Diagnosis – identifying illness accurately and detecting at an earlier stage
- Treatment– targeting therapies to genetic traits, reducing side-effects and decreasing delays in finding the correct treatment and dose
- Patient engagement– allowing patients to monitor health and take action and improving compliance
The Promise of Personalized Medicine
Personalized medicine could provide solutions to one of the biggest challenges facing our country – the rising cost of health care. Canada currently spends around $200 billion on health care each year, which is roughly one-tenth of GDP. As a 2011 Frasier Institute study indicates, Ontario is spending more than half of its total revenue on health care and “total provincial health spending has grown at an average annual rate of 7.5 percent over the last 10 years.”
Personalized medicine will dramatically change the medical care landscape by improving upon current knowledge of such things as disease progression and drug efficacy.
- Current practices for prescribing medication within classes of drugs are relatively arbitrary – performed using the ineffective ‘test and react’ approach – and many patients do not respond to the first medication they are prescribed. For example, on average, SSRI anti-depressants are ineffective for 38% of patients, and cancer drugs are ineffective for 75% of patients. Furthermore, there are an estimated 200,000 severe adverse drug reactions in Canada each year, which cost somewhere between $13.7 and $17.7 billion and result in 10,000 to 20,000 deaths. Diagnostic tests to identify whether a person will respond positively to a given drug, or have a potentially life-threatening reaction to the medication or dose, could save billions of dollars, increase the quality of care and prevent fatalities.
- Chronic diseases like cancer, diabetes, cardiovascular and chronic respiratory diseases currently affect two out of five Canadians above the age of 12, and are on the rise. In 2010, Canada spent 58 percent ($68 billion) of its total health budget on chronic care and chronic diseases cost Canadians an additional $122 billion in indirect income and productivity losses. Identifying high-risk individuals alongside early diagnosis and treatment will improve the lives of millions of Canadians and have a significant impact on our economy.
Opportunities and Challenges
A key driver towards personalized medicine is the dramatic increase in our ability to sequence DNA. It will soon be possible to sequence a patient’s entire genome at a cost and speed commensurate with other diagnostic tests. A typical diagnostic test offers insight into a single aspect of a single disorder, at a single time point, in a single patient. In contrast, genomic sequence data offers insight into a vast array of potential diseases, with predictive power not only for the patient, but the patient’s family. Genome sequencing is critical to understanding the heterogeneity among population groups in order to target the appropriate therapy to the appropriate group. It is a very different type of diagnostic test, requiring new tools and presenting new opportunities for research, drug development, and health management.
The emerging opportunity for personalized medicine in our healthcare system is contingent on the collection of this genomic data, as well as the collection, conversion, and mining of large amounts of complex data – such as patient data. Ontario’s health data landscape is prolific – but connections for such exchange of data between organizations are lacking. To explore and employ Ontario’s prolific Health Data Landscape will necessitate new tools, new talent, and new infrastructure. The OPMN spearheaded an investigation into Ontario’s health data resources and their lack of connectivity; View the Report.
We are at critical point in the advancement of personalized medicine. Progress in genomics and related fields have increased scientific knowledge, the cost of sequencing is rapidly declining and developments in data processing are translating this information into clinical application. Ontario has long been a world leader in scientific research and this knowledge could result in significant economic value, job and wealth creation. Countries around the world have recognized personalized medicine’s potential and are poised to take advantage of the benefits. Ontario has the opportunity to join them.
To seize this opportunity and integrate a personalized approach to health care in Ontario will take significant planning and investment. Inaction will result in missed opportunities for the province. Through analysis of Ontario’s current landscape, future opportunities and potential challenges, the Ontario Personalized Medicine Network (OPMN) will help Ontario achieve maximum benefit from this health care transformation
[¹] Spear, B.B., Heath-Chiozzi, M., & Huff, J. (2001). Clinical application of pharmacogenetics. Trends in Molecular Medicine, 7(5), 201-204.