​Identifying individuals at high risk for various diseases and pinpointing precisely what treatments are likely to be effective are at the center of “personalized medicine.” Jason Karlawish, MD, prefers the term “desktop medicine.” However, whatever term one uses, he stresses, “This will play a huge role in the care of the elderly in the coming years. It has as its core the concept of the biomarker and will radically reshape the border between disease and normal aging.

“In the case of common conditions such as Alzheimer’s, biomarkers will have the same transformative powers as LDL—so-called ‘bad cholesterol’—had with heart disease,” he says. “The number of persons at risk and in need of therapy will only grow.”

The personalized medicine movement grew out of the Human Genome Project, completed several years ago by the U.S. Department of Energy and the National Institutes of Health. The project’s goal was to identify specific genes that cause common diseases, such as AD. This type of medicine involves customizing medical treatments to the individual characteristics and genetic makeup of each person.

One important aspect of personalized—or desktop—medicine is pharmacogenomics, which lets clinicians use genetic testing to determine how a patient is likely to respond to a specific drug.
While this is still in the early stages of development, a bedside genetic test is not that far off. Within five years, nursing facilities actually could see availability of an affordable (approximately $1,000) bedside genetic test, experts say.

As the benefits of targeting treatments to individual responses are documented in the literature, pharmacogenomics and desktop medicine are likely to become more commonplace, and payers are likely to appreciate the positive impact on both costs and outcomes.