What’s Ailing Personalized Medicine? Mark Levin Calls for Leadership at the Highest Level
It started out business as usual at the Personalized Medicine Coalition’s East Coast reception at The Broad Institute last week. People were touting the big steps that have been taken to advance the vision of personalized medicine, in which the best treatments are chosen for each patient based on molecular tests, imaging tools, software, and other sophisticated tools. Then, venture capitalist Mark Levin sauntered up to the podium (in his typical casual style, sporting high top sneakers and a fleece jacket) and said “I’m thrilled by the advances, but at the same time I’m frustrated and disappointed by the level of progress.”
Levin’s got a good point. While the PMC itself has been very active, amassing about 120 members—including local firms Helicos BioSciences, BG Medicine, and Boston Millennia Partners—since its formation a few years ago, there is still a lot of foot dragging going on by others, particularly in the pharmaceutical industry and in Washington, DC.
One notable sore point is GINA, the Genetic Information Nondiscrimination Act that personalized medicine proponents believe is crucial to advancing the field. That bill has still not passed despite 12 years of effort. But that’s not the only problem. Big pharma companies have been reluctant to adopt the personalized medicine model, which involves drugs aimed at smaller patient populations than the massive ones that coveted blockbuster drugs target.
Levin was himself confronting the challenge of smaller markets for personalized medicines around the time he hatched the idea of the PMC in his office at Millennium Pharmaceuticals, based on discussions with Millennium cofounders Eric Lander and Raju Kucherlapati. Now a partner at Boston’s Third Rock Ventures, Levin was Millennium’s founding CEO; that company was built around the idea of personalized medicine, but (at least so far) failed to turn the idea into suite of products. Levin argued in a 2001 interview that personalized medicine would allow companies to get more, higher-value drugs approved more quickly, offsetting the fact that the market for each one might be smaller.
“We were so excited about [personalized medicine] when we started 12 or 13 years ago,” Levin said. But since things haven’t moved fast enough, he’s now calling for leadership from the highest political level to help speed the field along, arguing that personalized medicine could even help cut the deficit because it leads to better health care at lower cost.
Speaking before Levin, Kucherlapati, the scientific director of the Harvard Medical School–Partners Healthcare Center for Genetics and Genomics, said one big thing holding back personalized medicine is that so many of the players (e.g. doctors, insurers, and biotechs) are focused on their own interests. We can’t “continue to operate in our separate worlds,” he admonished. “We need to present a common vision.”
But Levin and Kucherlapati’s frustration was balanced by Lander, the evening’s first speaker and director of the Broad, who deftly described the “miraculous” advances that have taken place over the last few years in large-scale genotyping—the process by which genetic variations are quickly detected in many parts of the genome. “This is the most remarkable period in genetics,” Lander said. Those genetic variations, most of which are so-called single nucleotide polymorphisms (SNPs), are one of the key genomic tools for sorting out individual responses to drugs.
Genotyping has truly rocketed ahead. As PMC head Edward Abrahams said, you can already “take out your iPhone, Google ‘SNPs’, and get access to databases of more than 10.5 million SNPs.” And that message is finally reverberating into the business world, leading to a small flurry of new companies using those tools to develop new diagnostics and drugs.
Levin’s call for political support for the field notwithstanding, with so much activity on the tech side, personalized medicine could end up being of those areas where the technology pulls us to our destiny, rather than our leaders pushing us there.