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By Jihee Stephanie Yeh

Rapid development in techniques such as 3D printing combined with the need for personalized medicine is changing this era of pharmaceuticals. Public demand for better medicine has increased the hopes of achieving improved health care. For that, people seek a health care system that can support the extensive cost and effort to treat diseases in the long-term rather than the short-term.

Personalized medicine focuses on developing medicine tailored to each individual based on the patient’s information, such as genetic code, health data, and environmental profile. This information can be obtained from different diagnostic methods such as newly identified biomarkers, which then could lead to improved prognosis followed by alternative treatment options. Numerous treatments became available with 3D printing, which allowed pharmaceutical companies to easily modify physical properties of drugs to adjust to new doses without altering their fundamental function.

However, the emergence of personalized medicine using clinical diagnostics to determine selection and dosage of the drugs has a great impact on the health care system. For example, the efficacy of the drug warfarin can be affected by the genetic variation of CYP450 enzymes. Because of that risk, the dosage of the drug given to patients should be monitored to avoid any serious adverse effects.  Current health insurance policies including numerous coverages and reimbursements are solely based on a conventional approach to diagnostics and treatments. However, there are many challenges to modifying the health care system so that it can be suitable f0r a modern approach to diagnostics and treatments. These challenges include developing a proper reimbursement policy for tailored therapeutics, payment options for diagnostic tests, and reshaping the overall coverage and payment options.

To customize a medicine to a specific individual, a variety of information is needed, including not only patient health data, but also genetic tests and diagnostic tests. This leads to an increase in initial cost even before the actual treatment starts. In that case, health insurance policy would have to be modified to accommodate a broad spectrum of test methods for each category of diseases. Once the information is obtained, a customized drug can be available to a patient using a 3D printing technique. Importantly, 3D printing is expected to bring a reduction in the cost of producing tailored medicine. However, the health care company could argue whether the chosen treatment is the best option while there could be other options available at a lower cost and less efforts. Therefore, the coverage and payment options need more flexibility to account for the wide range of therapeutics.

Controversy on whether the techniques will reduce or increase the overall cost of health care still stands. As one of the advocates of personalized medicine, Dhruv Kazi, M.D., a cardiologist and professor at the University of California, San Francisco once expressed, “If you pair the right person with the right drug, then you can produce substantial savings” in long-term costs associated with individual patients. Many on the opposite side argue that it is the “chicken-or-egg” situation wherein that the benefits of personalized medicine may not show until a vast amount of money has been spent to achieve them.

The invention of varying techniques can bring prosperity to pharmaceuticals, but the question is: How can it be successful without recognizing the significance and acknowledging what else needs to be considered?

Jihee Stephanie Yeh is a Ph.D. student in the Department of Pharmaceutical Sciences at Mercer University. She currently works in an analytical toxicology lab developing HPLC-MS/MS methods for clinical diagnostics.