Time to level up testing and treatment

Peter Keeling, Susanne Munksted

At Diaceutics we maintain the view that better testing is critical in delivering better patient outcomes, and when aligned with targeted therapy, the two are transformative.

A recent Irish Times summary highlighting a new report from the Irish National Cancer Registry supports the first part of the below statement, and of course the continued increase?of precision medicine test-treatment combinations supports the second.

“Early diagnosis is leading to better cancer outcomes, including near-total survival at five years for some forms of the disease, according to a new report from the National Cancer Registry (NCRI). A high proportion of cancers affecting the skin (melanoma), uterus and prostate present at an early stage, resulting in five-year survival of “up to 100 per cent”, according to the NCRI annual statistical report.” - The Irish Times

So, what’s the problem? Simply this; Precision medicine will remain curtailed as a force for patient good by the inequalities of market reward and published outcome evidence between testing and treatment. For many in clinical and lab practice there is no surprise that better testing of patients has the potential to radically alter their life, yet newspapers present this fact as?revelatory.

?At Diaceutics we ask ourselves a different set of questions:

1. What is the right level of clinical risk/reward for better testing? (It is surely not the current 3% of all the monies currently spent in healthcare!)
2. What are the disruptive business models of tomorrow which will reintegrate testing and treatment at a system level? (It is surely not the current model where 65% of patients are denied access to precision medicine because of inattention to the diagnostic and treatment pathway and 30% of precision medicines fail to deliver an ROI as a consequence.)
3. Is it time to let “patients” take control of their own diagnostic pathway? (After all, decades of minor adjustments to the market-based regime run by current incumbents has not really resulted in the democratization of the testing market.)
4. What does Standard of Care look like in the march toward the N of One and true promise of precision medicine? (We are not ready, as systems and investments are set up to cater for the mainstream).
5. How do we ensure that the multiple new innovations in diagnostic biomarkers and technology, as well as novel treatments still to come, will not stumble in added complexity? (We all recognize that regulation and reimbursement for testing and data is historically managed in silos).

If all of this seems like a wicked problem, in actuality we have never been more equipped to “level up” testing and treatment – We have greater levels of real-world data to evidence the role and value of better testing in medicine, we have labs across the globe ready to be even more proactive in rapidly supporting better treatment choices, and of course we can clearly illustrate now how every treatment choice will benefit from the clinical clarity which flows from efficient diagnostic pathways. Most of all, the broader precision medicine community is now aware of the issues above… and 50% of addressing a problem is knowing we have one.

Imagine if together we can change newspaper headlines to “better testing now the next frontier for precision medicine”.

This LinkedIn article kick-starts a series of commentary from us on this topic. Perhaps you have examples of the levelling up mobilizing already… please share as we would love to see them.