Redefining the Health Industry

Personalized medicine doesn’t sound revolutionary. The Personalized Medicine Coalition defines the term as “the tailoring of medical treatment to the individual characteristics of each patient.” But every doctor is supposed to do that, right?

Right. But it’s never been fully possible before.Now it’s emerging as a global market, and Collier County is positioning itself to be a player. Early adapters are already putting its principles to work in the Southwest Florida medical community, and we can expect to see more in the not-too-distant future. The Jackson Laboratory, a national leader in this field, is tentatively set to open an institute arm here in late 2011. Construction could begin before the end of 2010.

These are exciting developments to everyone who’s heard of this pioneering field. If you haven’t, you will.

What Makes it Personal? 

Until recently, medical diagnosis and treatment have been largely based on educated guesswork informed by a patient’s clinical signs and symptoms, medical and family history, and laboratory and medical imaging data. Even so, the basis of treatment is a statistical correlation based on “large cohort”: studies of patients. Strictly speaking, your prescription isn’t really tailored to you at all. 

But thanks to the Human Genome Project, which mapped the genetic composition of human beings in 2003, the age of guesswork will soon be over. Targeted diagnostics and therapy based on an individual’s genetic makeup is now a reality, and having tests and treatments personalized to you can change our approach to healthcare.

Just ask H. Louise Brown. The 70-year-old Naples woman loves to read, but it was getting hard for her. “My vision was getting blurry at night,” she says. “Sometimes I couldn’t see the words on the page of a book I was reading. It scared me. My uncle had macular degeneration and I was afraid that I was developing the disease.” 

Age-related macular degeneration (AMD) is the leading cause of blindness for people over age 55. It’s an insidious, progressive disease that affects approximately one in 23 individuals in the United States. Risk factors include genetic variations, age and history of smoking.   

Brown consulted with Dr. Alexander Eaton, an ophthalmologist whose Macular Degeneration Research Center, with Fort Myers and Naples offices, conducts studies to determine the effectiveness of investigational drugs and delivery methods in preventing and treating AMD. Since genetic variation is one of the major risk factors and Brown had a family history, Eaton advised her to undergo a macula risk test to determine her level of genetic risk.  

The test analyzed a sample of Brown’s DNA for gene variations (SNPs, called “snaps”) associated with AMD. The news was good. 

“It turns out I have a low chance of getting AMD as I age,” Brown says. “The results show I have a 9 percent chance of developing the disease by age 80. I can tell my children and siblings that my risk is minimal. This will give the whole family peace of mind that I won’t get the disease.” 

Eaton points out that even bad news can be useful. “The test allows us to closely monitor patients with a higher likelihood of developing the disease due to a family history or other risk factors. If a test indicates that the patient is at an increased risk for AMD, we can recommend vitamins and healthy lifestyle changes that may decrease the risk. We can also prepare the patient for future treatment options.”

Working into the mainstream 

The genetic test for AMD hit the market in 2009, joining about 1,000 other genetic tests that are currently available from testing laboratories. Although this particular test is new, the field itself isn’t. Genetic testing has been around for years, but it’s taken insurance companies a while to catch up. Insurers such as Medicare, Blue Cross/Blue Shield and Cigna recently announced that they would cover the AMD test. 

In the decade ahead, expect more of the same. Insurance companies are starting to recognize the efficacy and cost-effectiveness of early treatment that genetic testing makes possible. You can also expect genetic tests to become more sophisticated and more commonplace. What began as a cutting-edge offshoot of the medical industry is sure to become a major part of it. 

The advocates of personalized medicine have a simple, immediate goal: Offer targeted diagnostics and therapeutics based on knowledge of an individual’s genetic makeup. “Today, we can understand the precise chemical sequence that makes up who we are,” explains Jackson Lab’s Michael Hyde, vice president for advancement and external relations. “We can relate the differences between states of disease and states of health. This has only been possible within the last 10 years—to be able to design medical treatment based on your specific chemical makeup. Instead of getting treatment based on what works for most people, you will be able to get treatment based on what specifically works for you.” 

So if the technology to make medicine truly personal is there, why haven’t more people undergone genome sequencing? The answer is cost. 

“Fewer than 1,000 people have had their genome sequenced,” says Hyde. “The reason is simply that it costs between $30,000 and $40,000 to have your DNA sequenced. Within five years, though, that could change. We could get testing down to a cost level where we could do a DNA sequence of every newborn baby. We could get the cost down to about $1,000.” 

This is the kind of research going on at The Jackson Laboratory, a leading, nonprofit biomedical research institute founded in 1929 in Bar Harbor, Maine. And it is the kind of research that could find its way to a new facility in our own backyard. 

Today, this research powerhouse has another branch facility in Sacramento, Calif., but demand for its research is expanding. The institution recently announced plans to establish a branch Institute for Personalized Medicine and Research Village somewhere else in the country—a new, $710 million facility dedicated to the field of personalized medicine. If everything goes according to plan, the facility will be located in Collier County. 

An economic boon 

In March 2010, the Florida Senate’s Ways and Means Committee earmarked $50 million from the state budget for the 2010-2011 fiscal year to entice The Jackson Laboratory to establish its new branch in Florida. The total allocation is $130 million over a three-year period. If the deal goes through and if the rest of the funding can be generated from other sources, such as the National Institutes of Health and private philanthropy, the institute will come here.

According to state Sen. Garrett Richter’s testimony before the committee, the economic impact would be profound. The facility would create an estimated 420 high-paying jobs in the first year, more than 7,000 jobs in the next 10 years and an economic impact of $835 million in the coming decade. The allocation was overwhelmingly approved.

The facility would serve as both research campus and applied research hospital where its scientists would put their research into personalized medicine into practice. 

A Jackson Labs facility in Southwest Florida could profoundly change the local business community. According to a recent report by PricewaterhouseCoopers LLP, “Personalized medicine is redefining the health industry and disrupting existing business models.” The study estimates the current market for personalized medicine to be $232 billion, and as the new science grows, the market for patient-specific diagnostic tests and therapies will expand. The report projects an 11 percent annual growth and a market of more than $450 billion by 2015 in “traditional” medicine alone. Peripheral markets for personalized medicine—including alternative medicine, wellness and nutrition—add up to $196 billion today, and the report estimates they will grow 7 percent annually to more than $290 billion by 2015. 

Collier County is up for the challenge. The movement to bring a major scientific player to the area started several years ago with the creation of Project Innovation, an Economic Development Council of Collier County initiative to create “an environment by design” that would attract new industry to the area, says EDC President Tammie Nemecek. “The community’s strategy has been to target specific industry clusters such as health and life sciences and bring them to Collier County.  We have been working with the county commission and private citizens to put the pieces in place so we could attract a catalyst institute here such as The Jackson Laboratory,” Nemecek says. “We have a great base of healthcare here in Southwest Florida and are excited at the prospect of Collier County becoming an epicenter for personalized medicine.”