I support this approach. Today drugs are made for the masses. They are not the most efficacious, nor the least risky. But they can treat most people most of the time. Limited risk allowing allows for a scalable go to market strategy. However, custom drugs are not the same as risk free drugs. There is no free lunch in life, and healthcare. Complications will continue even with the most tailored therapies. In some sense, PM is just another expression of medicine "American style," suggesting if you throw enough technology at a problem, the problem will go away- if only.
Another version of PM looks to measure the patient. Though a series of devices, from Fitbit to blue tooth scales for obesity and heart conditions, the "quantified self" can learn, change and improve. Customized intervention is presumed to follow. Except for a few medical conditions (CHF and COPD, ...not diabetes), this approach has not been a viable business model. Most of the devices have been relegated to the Super-fit, a small, selected and (to most of us more sedentary) annoying sub-population of triathletes and overall smiley do gooders. The market is largely based on income for luxuries rather than related to healthcare. I have always been surprised how one biometric, well-being, has largely been ignored. How the person feels (are they in pain, are they depressed) could be gathered via texting or automated phone calls. These issues have as much to do with health and long term value as blood pressure or weight.
Ultimately, truly personalized medicine requires the patient (or even better, the person), to make a choice about their care. Today, choice is visibly absent. A risky and painful therapy may be right for someone wanting to see their daughter wedding, but completely wrong for another. Even codified issues of medical consent remain murky. Before surgery, how many of us truly understand are options and the predicted outcome of each choice? Most physicians have typically arrived at a decision before offering consent. The process becomes more of a legal requirement rather than an opportunity for choice. These small decisions lead to an unintended destinations so pervasive in healthcare. Patient satisfaction suffers, while simultaneously utilization increases with little perceived value.
The dialogue around personalized healthcare is needed. However, let's not make it simply an extension of the current techno-medicine culture. There will always be pain and suffering- and ultimately (say it ain't so in America) death. To truly personalize medicine, a relevant discussion about the risks and benefits of every drug, every surgery, every choice would put the "P" in PM.
