Academic Review 2024

43 ACADEMIC REVIEW 2024

On the surface, it may seem obvious that further implementation of personalised medicine in the NHS would lead to remarkable progress in the degree of treatment that doctors could provide. This is backed up by the council of the European Union, who have stated that, ‘The development of personalised medicine may offer new opportunities for the treatment of patients… allowing healthcare providers to offer better targeted treatment, avoid medical errors and reduce adverse reactions to medicinal products’ (Horgan, 2016). Furthermore, the director for disease registration and cancer analysis at Public Health England, Jem Rashbass, has stated that, ‘Personalised medicine isn’t overhyped’ and, ‘It is spectacular when it works’ (Armstrong, 2017). Former US president Barack Obama has also stated that personalised medicine could The science behind personalised medicine Personalised medicine is providing treatment in the context of the genetic makeup of an individual, with the aim of tailoring treatments to the particular genotype present in patients. This allows for higher efficacy, specificity and reduced adverse effects. Genome sequencing is the basis of personalised medicine. A genome is the entire sequence of bases in the DNA of an organism, and a copy can be found within the nucleus of every cell in the body. By analysing the sequence of bases in an individual’s genome, scientists can identify which drugs would be the most effective to prescribe and which treatments would work best with the least amount of side effects. For instance, a common treatment for cancer is chemotherapy, which comes with a plethora of side effects such as hair loss, anaemia and vomiting. However, targeted cancer treatments that act on individual cells are shown to have fewer side effects. Doctors can also identify an individual’s susceptibility to many diseases, and thus take preventative measures to reduce the individual’s risk. This approach to healthcare is in line with the NHS’s aim to transition further away from an antiquated treatment-based healthcare system, and towards a more advanced, prevention-based healthcare system.

But how have we been able to come so far with genome technology? The initial sequencing of a full human genome took, ‘over 10 years and cost more than £2bn’ (Turnbull, Scott, & al, 2018), but now we can sequence a genome in less than a day, with it costing no more than £700 (Turnbull, Scott, & al, 2018). Incredible work such as the Human Genome Project and the 100,000 Genomes Project have both played an integral role in developing our understanding of genomics. The Human Genome Project was an international collaboration between scientists with the primary aim, ‘To improve the research infrastructure of human genetics’ (Olsen, 1993) by identifying the sequence of bases in DNA and mapping out the first complete human genome. An interesting conclusion that was reached is that human genomes are 99.9% identical. The Human Genome Project is said to have laid the groundworks of genomics and to have revolutionised personalised medicine; it, ‘Gave us the ability to read nature’s complete genetic blueprint for a human’ (National Human Genome Research Institute, 2021). ‘bring us closer to curing diseases like cancer and diabetes’ (McCartney, 2017), which we have been struggling to fight for decades, despite major funding. However, there is an abundance of issues associated with personalised medicine. Margaret McCartney, a general practitioner, has stated that personalised medicine is, ‘A recipe for unhelpful early diagnosis, false alarms, poor sensitivity, and conflicts of interest’ (McCartney, 2017). By exploring ways in which personalised medicine is already being used within healthcare, this essay will investigate both the potential and current benefits as well as the barriers associated with the further implementation of personalised medicine in the NHS, and come to a well-rounded conclusion on the overall suitability of personalised medicine and whether or not it holds the potential to be, and should be, further integrated into the NHS.

“ Personalised medicine isn’t overhyped. ”