1 - Personalised medicine – a revolution in healthcare

Summary

There are few words so widely disseminated and belonging so naturally to modern political vocabulary as the term ‘revolution’.

Reinhart Koselleck (1985:159)

It was a most peculiar newspaper headline. On 8 December 2003 the British broadsheet newspaper the Independent announced: ‘Glaxo chief: Our drugs do not work on most patients’ (Connor 2003a). The subsequent report covered a conference at which Allen Roses, vice-president of genetics at the pharmaceutical giant GlaxoSmithKline, admitted the ‘open secret within the drugs industry that most of its products are ineffective in most patients’ (Connor 2003a). Yet rather than this being a cause of outrage and falling share prices, for Roses and others like him in the industry such an admission is the first step on the road to a revolution in the way drugs are developed and, in the long run, how healthcare is provided. For Allen Roses ‘is a pioneer of a new culture within the drugs business based on using genes to test for who can benefit from a drug’ (Connor 2003a). And it is this use of genetic testing to develop and prescribe drugs, pharmacogenetics, that will drive the coming revolution. As Roses states, ‘Pharmacogenetics has the promise of removing much of the uncertainty’ that surrounds current drug use (Connor 2003a).

Industry's intense interest in pharmacogenetics and genomic technologies as a whole is relatively recent, dating from around 1997, but it has stimulated considerable investment on the part of pharmaceutical companies.