Article

Win three to seven years in good health

Personalised care can greatly improve diagnostics and treatments, reducing the burden of disease by 15 to 30%. Dutch people can gain three to seven years in good health that are now lost to disease or premature death.

The Dutch healthcare system is in a state of flux. From one and the same treatment for all, we are moving towards care that is tailored to the individual. This form of care is called precision medicine.

Technologically speaking, the transition to precision medicine has accelerated: there are more and more, increasingly precise diagnostic and treatment options focused on individual patient characteristics. However, the problem is that the healthcare system lags behind these developments, with the result that innovations do not sufficiently reach practice. In the study 'n=1, a new paradigm', Gupta Strategists examines the potential health gains if technological innovations were more widely deployed. What challenges do we face to get there?

The study shows that with wide use of current technologies, we can regain 3 to 7 years of life in good health that we currently lose to disease or premature death. Oncological diseases currently lead the movement towards precision medicine, followed by chronic diseases such as stroke, diabetes and COPD. Psychiatric disorders lag behind, while the burden of disease for the Dutch population is high.

A number of barriers stand in the way of these health gains. These barriers relate to 1) generating the evidence base for precision medicine, 2) collecting data, 3) combining and using data, 4) translating data into decision support, 5) increasing the confidence of the population and practitioners and 6) aligning the economic frameworks within the healthcare system with precision medicine.

Many, often small-scale, initiatives have already been set up in the Netherlands to break down these barriers. In this study, we give an overview. Collective action is needed to create a sustainable system that is receptive to precision medicine. As a society, we will have to make safe and large-scale data collection a priority. It is also important that Dutch citizens and healthcare providers are convinced of the value of sharing personal data. The government has an important role in adapting legislation and economic frameworks to better reflect the dynamic and personalised nature of precision medicine. "It is time for collective action to harvest the value of precision medicine."

A comparison of current diagnostic and treatment standards with state-of-the-art diagnostic and therapeutic possibilities shows that progress in precision medicine is expected across all disease groups. This progress leads to a total disease burden reduction of 15-30%, which translates into 3 to 7 healthy life years gained. To put these figures into perspective, this means that the area south of the Rhine would be completely disease-free by now.