Penn's Emanuel is a 'big skeptic' of health-care savings on drugs targeted to individuals

Plenty of folks in medicine and pharmaceuticals hope that targeted therapy and personalized medicine will lead to better treatments - and big revenue. But the University of Pennsylvania's Ezekiel Emanuel says hold on a minute.

The life science industry theory is that after genes are spliced and diced to create a drug specifically tailored for a real, live human named Bob or Emily (more on her in a moment) , no government (taxpayers) or private insurers (policyholders) is going deny reimbursing the high price applied by corporations and their sometimes non- or not-for-profit partners.

Emanuel, a doctor and bioethicist, is vice provost for global initiatives and chairman of the department of medical ethics and health care policy at Penn. He worked with the White House in formulating the Affordable Care Act.

Emanuel moderated a panel on health care costs Thursday at the Wharton Economic Summit 2013 at Jazz at Lincoln Center in Manhattan. The panel followed a opening discussion with GE chief executive officer Jeff Immelt, who said, among other things, that consumers need to bear greater responsibility for their health and pay more for care. A link to Friday's Inquirer story on that is here.

Gary Gottlieb, the president and chief executive officer of Partners Healthcare and a psychiatrist by training, was on the health-care panel, along with Johnson & Johnson CEO Alex Gorsky, Princeton professor Uwe Reinhardt and Venrock partner Bob Kocher, whose venture capital firm focuses on health-care IT and service companies.

Gottlieb got his MBA at Wharton, held several positions in Penn Medicine and was CEO of Philadelphia's Friends Hospital, the nation's oldest standalone psychiatric hospital. Based in Boston, Partners Healthcare is a not-for-profit health care system founded in 1994 by Brigham and Women's Hospital and Massachusetts General Hospital, and includes community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities. The web site notes it is a teaching affiliate of Harvard Medical School and is a national leader in biomedical research.

With all of that in mind, Gottlieb was discussing the potential for targeted therapies on Thursday when Emanuel interjected, "I'm a big skeptic that will save a nickel."

Indeed, Emanuel expressed the same sentiment in a March 6 story published by Knowledge@Wharton, entitled, "The Promise - and Perils - of Personalized Medicine." A link is here.

The Wharton story notes the December announcement of "a much-heralded leukemia treatment pioneered at Children's Hospital of Philadelphia (CHOP) that uses tweaked versions of patients' own cells to eliminate their cancer. While these advances are certainly exciting for patients, they raise a host of ethical, legal and financial challenges that people working in the field will need to address before personalized medicine can become a thriving business."

An Inquirer story about the CHOP gene therapy efforts, led by a Penn researcher, and a 7-year-old Pennsylvania girl named Emily is here. The technology, by the way, was licensed to pharmaceutical giant Novartis.

The Knowledge@Wharton story says the challenges are so great, according to Emanuel, that claims of a renaissance in medicine brought on by individualized approaches often seem hyperbolic.

"Before we buy into this, we need to remember that almost every evaluation of what drives health care costs up points to new technologies," Emanuel is quoted as saying. "We need to be skeptical. We need to see the data before people buy into the idea that personalized medicine is going to produce cost savings and be so much better for the system."