The development by pharmaceutical conglomerates of new medications has stagnated
during the past decade due to the expense of development and clinical trials
that is rising exponentially, according to Prof. Giora Feuerstein, chief medial
and technical officer of the US Department of Defense.
The US physician
and pharmacologist, who is a veteran expert in translational science and drug
development in US pharmaceutical companies and was trained at the Hebrew
University of Jerusalem, was speaking at the Presidential Conference symposium
on “The Future of Medicine.”
(Translational science is cross-disciplinary
research that seeks practical applications that help people.) Feuerstein told
the audience of some 200 that the making of medicine is “everybody’s
business.”
But the fact that the costs of new drugs are unsustainable
means that pharmaceutical companies buy each other out, drug developers become
unemployed and there are fewer new and more effective medicines. It needs a new
business model, he declared, and this must be a consortium bringing together
governments – especially those with national health insurance systems as in
Israel – and academia.
“They must come down from their ivory towers and
help,” Feuerstein said. “Private industry cannot do it alone, and there must be
globalization of medical information on diseases.”
He said that medicine,
as we know it, will change completely and that the signs are already here. Terms
like proteomics, genomics and metabolomics will be common terms used to predict
what diseases people will develop years before their symptoms actually appear.
“To deal with the ageing problem, we will have to begin at an embryonic level or
at birth, saving the placenta and umbilical cord and freezing them,” said
Feuerstein.
Years or decades later they could be used for organ
engineering to provide replacements for sick ones, before the medical problem
begins, he added.
“We need an integrated system biology, a package of
information that is always on board. The capabilities [of healing] will always
be there. We are moving to a totally different era. In the last 50 years, the
foundations for synthetic biology have been laid... On this basis, we could
built new organs... You will be able to treat yourself by ‘your self.’ One could
even say: “I want better muscles to win a marathon; it won’t have to be disease
oriented.”
David Agus, professor of medicine and engineering of the
University of Southern California, as well as co-founder of Navigenics, a
personal genetic testing company, recalled giving an interview to Nightline on
ABC TV. He sequenced the DNA of the host, a seemingly healthy 42-year-old man,
and found that he was at high risk for heart disease. After conducting a
catheterization scan, which Agus said costs only $79, the star was found to have
a 80-percent blockage of a coronary artery, which was “fixed” in a
hospital.
“The next day, the American Heart Association called to protest
why I screened him for heart disease. I was told that the man was not eligible
for screening, as he was too young. If everybody got screened, there would be
chaos,” he was reprimanded.
Dr. Uma Raman Kotagal, a neonatologist and
health services researcher by training and senior vice president for quality and
transformation at Cincinnati Children’s Hospital Medical Center, was less than
optimistic. “Healthcare is often unsafe and ineffective, wasteful and
inefficient.”
She advised people who had to be hospitalized to take
someone with them to check the medications they were given and generally keep an
eye out.
She also noted that half of patients have to wait 17 years on
average before a new medical technology benefits them.
But the Internet
and social networks, she said, are already beginning to spread medical knowledge
and experience among patients, who would report their progress and feeling that
would add to medical knowledge. “We are creating communities of care, teams of
pediatricians and computer scientists, for example, that turn doctors and
patients into collaborators for new knowledge.”
Hebrew University Prof.
Hermona Soreq, a pioneer in molecular biomedicine, concluded that disease needs
“system engineering, not only one doctor and one patient. We need earlier
diagnosis methods.
Human beings are different, which means that in
clinical studies, we need a lot of individuals, which is hard in a small country
[like Israel].”
But she described promising Parkinson’s disease research
she has done with her HU and Hadassah University Medical Center colleagues using
little glass chips with data to get a profile of patients’ gene expression and
differentiate between healthy or sick individuals.
These signature genes
reflect the effect or neurological surgery in which electrical pacemakers can
control severe palsy.
“Now we have to find out which gene is a button on
which we can press to stop effects of the disease, just the way deep-brain
stimulation did,” she said.
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