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Personalized Medicine Changing Primary Care

Recently I attended a two-day conference on personalized medicine organized by Health Canada and the Canadian Institutes of Health Research. Many of the Canadian leaders in oncology and genetics were present. Pharmacy changes the most when the drugs themselves and how we use them change. The development of pharmacogenomics is probably going to bring some of the greatest changes in therapy since the tablet and synthetic drugs.

By detecting specific features of our genetic make-up, the so-called biomarkers, clinicians are able to predict severity of disease, responsiveness to specific drugs and the likelihood of adverse drug reactions. To date developments have focused on oncology but the approach has applications in other areas such as heart disease and infections.

It struck me that this is where regulation is trying to keep up with science, and policy, particularly with respect to access to these expensive diagnostics and treatments, is trying to keep up with regulation. It was clear that in a number of provinces, particularly BC and Québec, collaboration among academics, clinicians, researchers in a number of disciplines, hospitals and governments is already in place. In Québec there is also a strong link with the pharmaceutical industry. (Genome British Columbia and Consortium de Recherche en Oncologie Clinque du Québec are good sources for more information about these developments.)

While pharmacists in hospitals and researchers in Faculties of Pharmacy are engaged in some of these developments, an emphasis at this meeting was the need to engage professionals in primary care, as well as patients. It was announced that for $1000 a company will provide you with your own personal genome. The joke was that in five years teenagers will have their genome on their smart phones. Needless to say, enormous ethical, social and legal issues loom.

CPhA will definitely be watching this area as it develops, to understand how it affects pharmacy and what it means for our members.

Thanks for joining us,

Jeff Poston,
Executive Director