Smart cards for health care’s future?

Before the end of the decade, patients may be arriving at the doctor’s office with their personal genetic information encoded on a smart card to help their physicians tailor their treatment. But who else will have access to that personal information? Those were among the visions and concerns for the future of health care presented at the fourth annual Pharmacogenetics and Medicine Lectures at the School of Medicine in early April. The conference brought together experts in genomics, medicine and policy to discuss the changes in medicine resulting from emerging information about the relationship between an individual’s genetic makeup and both the health benefits and detrimental side effects of medications.

Pharmacogenetics is the rapidly developing field that applies new tools based on genetic differences to drug development and, eventually, to choosing the best treatments for patients. The morning-long event in Harkness Auditorium drew nearly 200 attendees from the medical school and from biotechnology, pharmaceutical and venture capital firms around the Northeast.

Gualberto Ruaño, Ph.D. ’92, M.D. ’97, is chief executive officer of the conference sponsor, Genaissance Pharmaceuticals, a New Haven firm that is discovering the associations between genetic variations and clinical outcomes that will make those smart cards possible. He predicted that within the next five to six years smart cards will begin to be a part of health care practices and will quickly become standard medical technology for prescribing medications. Genomics, he said, can be predictive. “At the end of the day, our purpose is to create a genetic PDR,” the equivalent of the Physician’s Desk Reference used by doctors for guidance in prescribing medications.

Gail Wilensky, Ph.D., is a senior fellow at the Center for Health Affairs/Project HOPE, an international health foundation, and chair of the Medicare Payment Advisory Commission, which advises Congress on Medicare issues. She pointed out that there is a great deal of skepticism about the current value of health care relative to costs, but was optimistic that pharmacogenetics will receive support. “The promise of better targeting of pharmaceuticals,” she said, is “better value for our money.”

Medical ethicist and Professor of Medicine Robert J. Levine, M.D., HS ’63, noted the importance of maintaining patient privacy and making improvements in health care as a result of pharmacogenetic advances becoming widely accessible. Without dealing with public fears, achieving personalized medicine may not be so easy, warned Alan McGowen, president of the Gene Media Forum, a public information organization that focuses on biomedical science. “We can avoid the pitfalls,” he said, “if we take a very strong stance in educating the public about the benefits and are honest about the risks in this research.”