Transcript
Announcer:
This is Clinician’s Roundtable on ReachMD. On this episode, Dr. Pilar Rivera Ortega joins us to talk about where the greatest opportunities are to advance precision medicine for patients with fibrotic interstitial lung disease. She’s a Consultant in Respiratory Medicine at the Royal Devon University and Exeter Hospital, as well as an Associate Research and Development Director for Royal Devon University NHS Foundation Trust in the United Kingdom. Let’s hear from Dr. Ortega now.
Dr. Ortega:
In terms of future directions for precision medicine, it's more like a plea or call to action for all stakeholders—clinicians, researchers, patients, caregivers, and all the stakeholders from the health authorities' point of view, like managers and everyone that is involved in patient care. We have a lot of information, but we need to know how to integrate this information. One of the future directions is with all of these amazing biomarkers that have been published and we have nowadays, what could be the biomarkers that we will choose? We need to start integrating them, and the most important thing is to be flexible and to be able to adapt to the different health system realities.
We cannot only think that everybody has the same equal access health system that we have, for example, in the UK or in terms of insurance like in the US. We have countries and entire continents that don't have an equal access health system. They don't have insurance so patients need to pay for the treatment, and patients cannot afford that. And clinicians are desperate because they cannot offer the treatment that their patients need. So in that case, it's not a lack of education. It's not that the health authorities don't want to grant these treatments. Some targeted problems are above and beyond our understanding.
So we need to start thinking about what will be the type of solution that all the stakeholders, including regulatory authorities and ministries of health, will need to be able to go one step forward. And what we need are cost-effectiveness analyses, we need some type of Markov model, and we need to see in a broader spectrum all of the journey—from the first symptoms that the patient has and the first primary care visit to what triggered the first X-ray or the first CT scan. And all throughout this journey, how many times was, unfortunately, the patient misdiagnosed and how many times was the patient going to A&E or to a general pulmonologist because it was a different type of diagnosis until we have an accurate diagnosis. So it’s about the entire journey of this individual and also the impact on relatives, like how many times did they need to stop going to work and the impact as well in all the spheres—not only physically, but psychologically and emotionally. I think it's a bit more with a broader spectrum. When we have this, that is the future direction.
So we have brilliant biomarkers. We have a lot of information, but how can we use this information now in a way that could be sustainable and feasible and that we will be able to extrapolate? And also, we need to start talking in a language that all stakeholders would be able to understand as that’s the most important thing that we have been missing for ages because we are only dedicated to investigate, and we are very excited as researchers. We need to think about implementation, and we cannot think about implementation if we don't have cost-effectiveness analysis.
Announcer:
That was Dr. Pilar Rivera Ortega talking about the future of precision medicine in fibrotic interstitial lung disease. To access this and other episodes in our series, visit Clinician’s Roundtable on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
