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Precision Medicine
LIFE
by Chris Sheedy
Made to measure
Precision medicine could have a powerful effect on insurance, particularly the life and health lines. But its reliance on genetic testing presents ethical dilemmas for how insurers can use the information.
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n the 24 hours before he spoke to the Journal, paediatric oncologist Professor Nick Gottardo was beginning to decode three precision medicine puzzles. Their solutions will carry great weight in a life-or-death outcome for three children with brain tumours. Each one is a real-world example of the potential of a personalised treatment, versus traditional protocols that take a one-sizefits-all approach. Precision medicine, as it’s known, typically relies on testing the genetic make-up of the patient. While it can offer tailored medical solutions, it also raises ethical dilemmas insurance professionals continue to wrestle with.
Brave new world
Precision medicine is a relatively new direction in therapy that promises better outcomes, fewer side effects and a muchimproved quality of life for people who otherwise had little chance of survival, or who faced the prospect of ongoing medical issues resulting from their treatment. While Gottardo specialises in the treatment of childhood cancers, precision medicine is also being used to treat adults with breast cancer, melanoma, colorectal cancer and many more life-threatening diseases. In some instances, tests establish if cancer cells exhibit a certain gene or protein changes that are being targeted in clinical trial by a new medicine. This gives researchers better information on how a new treatment works, and it can get patients better outcomes.
JOURNAL // ISSUE 04 2023 // ANZIIF.COM
“[Precision medicine] has become embedded in our day-to-day practice for making the diagnosis, assisting with the diagnosis or refining the diagnosis, and to find specific treatments that are more effective and less harmful,” says Gottardo, co-head of the Telethon Kids Institute’s Brain Tumour Research Team and head of the Department of Oncology and Haematology at Perth Children’s Hospital. “It is most commonly used when you’re talking about cancer. In children, it helps rationalise how much therapy a specific child needs. If you undertreat a child with a specific tumour, their chance of relapse is higher. Conversely, if you overtreat them, you’re causing more side effects.”
What does precision medicine mean for insurers?
Insurers, particularly those in the life and health spaces, are watching the development of precision medicine with great interest. Giving people access to the most effective treatment with the fewest side effects is in everyone’s best interest. However, few insurers are willing to comment now on how it will affect their underwriting and their products. In Australia, a moratorium is in place, preventing insurers using genetic test results to discriminate against customers who might apply for health insurance. Life insurers are permitted to use genetic test results in limited ways, and Treasury is currently reviewing regulations. In New Zealand, people have no protections in terms of how their genetic test results are used.