Having just edged the wrong side of 40, I discover I have ‘raised’ cholesterol. It’s not a big surprise as my father has had almost pure butter running through his veins since about my age. Medical science wants to study him to figure out how he is still walking and talking 38 years on. I have a theory that food preservatives have pickled him.
Knowledge of family history has been a standard question for GPs for years; and as science marches on in the mind boggling task to unencrypt the genome, we can now study our own DNA and discover our pre-disposition to all sorts of medical ills, and learn what to do to increase our chances of prevention.
At the same time, embryonic research studies are beginning to uncover just how differently we all respond to exercise; some of us get lots of benefit from just a little exercise, others have to work very hard to achieve the same health outcomes. And few of us can avoid the bombardment of ‘fat’ programmes on the TV that tell us over and over that hormones and genetics, as well as lifestyle, contribute to obesity.
So we are now better equipped than at any other time in history to study an individual and, based on family history, genetics and lifestyle, tailor a programme of diet, exercise and preventative medicine to maximise that persons chances of living a long, healthy life. As I read recently, the first people to live to 130 are probably already alive on the planet today.
So the opportunity to personalise is there, but is the will? Economic factors are also pushing us down this track. With an ageing population and an ever increasing plethora of drugs to treat then with, the heated debates about the future of the NHS are centred around the reality, on which there is no debate, that complete healthcare can no longer be offered for free to everyone, so change is inevitable. The NHS and NICE are faced with the unenviable task of deciding which drugs are funded into the NHS and which are not; and the NHS must use the data they have on patients much more effectively to prevent problems developing rather than treat them as they occur if budgets are to stay manageable.
This leaves the drugs companies with a conundrum. They can no longer rely on developing a drug and selling it into public healthcare systems around the world. Some perfectly effective drugs will no longer be supported and they will be forced, if they want to recoup their R&D millions, into finding B2C markets. But these won’t be cough and cold remedies with general appeal that can be carried by retail pharmacies; these will be niche drugs for niche conditions. The drugs companies will be forced to find ways to identify their audience and communicate directly to them.
Health insurance companies will be faced with the same cost pressures. Premiums can’t keep escalating indefinitely to cover all manner of treatments. Pretty soon the current flexible package trend (ie, you choose what is covered) will be supplemented with personalised health checks for prevention providing a way for Health Insurers to keep costs down and differentiate their position in the market place. Similarly, as more is known about exercise, subscription gyms will see this as an opportunity to specialise and differentiate themselves against their competition, offering further tailored exercise programmes and classes.
As more and more treatments and drugs are excluded from standard healthcare routes (both private and NHS), a cottage industry of niche treatment centres will pop up. NHS trusts, now pitted against each other and the private sector, will also need to make decisions about their specialisms and find a way to communicate those to GPs and patients.
What does all this mean? Some of the millions spent on marketing healthcare and exercise every year will be poured into identifying and communicating to niche audiences and into collecting customer information that allows tailoring of products and services direct to the consumer. The consumer will undoubtedly share this information, if collected in the right way, because the benefits to them will be clear and undeniable. But the healthcare and exercise industries will need to start from a low base knowledge of how to collect and store this information and how to act on it in a tailored way.
Watch this space, the revolution is near….