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3 Billion Base Pairs
for $1000 – What a bargain!
Soon, the price to have your entire genome sequenced will be
as cheap as $1000 dollars (not including analysis). This can potentially give you
insight into disease predispositions, access to appropriate treatments, etc.
However, with this comes more public access to the technology, challenges in
our already fragile health system, and concerns for governmental regulatory
bodies. After reading this article, and using your knowledge gained from class
and readings:
What do you think the $1000 genome’s impacts on public
health, medical professionals, and/or governmental policies will be?
Now that the $1000 genome is not far away, I think it’s important to start thinking about what kind of impact it will have on public health, medical professionals and governmental policies. In terms of public health, I think a less expensive genome will definitely be used in combination with primary preventive measures. More individuals will have screening available to them and preventive measures can be taken to stop or slow disease from happening.
ReplyDeleteMedical professionals also could see a difference in their practices in that they will likely start to encourage certain preventive efforts if an individual is found to be a carrier of a gene that may cause disease. They may also be performing more preventive procedures on these same individuals.
Government policies may also be affected significantly. In particular, insurance policies may start to change. More insurance carriers will likely incorporate genetic testing into their policies so that more individuals are able to access the procedures. Non-discrimination policies will also have to change if more individuals have access to their genetic information.
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ReplyDeleteWith genome sequencing becoming more readily available, we will have to establish policies related to this service. From a public health perspective, they will need to help educate potential patients on genome sequencing. They could promote the benefits of genomic sequencing, such as checking for worrisome mutations and obtaining information to personalize treatments. When this service does become readily available, I feel that genetic counselors will play a larger force in the medical world. With more testing being performed, you will need genetic counselors to educate the patients on the positive and negative aspects of getting tested. They will become essential in relaying information between doctor and patient. I agree with my classmate that insurance companies will also have to change and start to cover genetic testing and sequencing.
ReplyDeleteThe government will also be involved by regulating how the genetic information gained is protected. We will have to establish strict guidelines on how our genetic data will be protected.
I think that the $1000 genome could mean great things for the future but like the article states, I don’t think that governments, the medical system, or the general public are ready for it yet. In public health, the genome could definitely allow for more screening like Kate mentioned. But then I think of many countries where $1000 is completely unheard of because they can’t even afford to spend $1 on water and I second guess how life changing this new genome sequencing plan could be.
ReplyDeleteI think this $1000 genome would best impact medical professionals because they would be able to detect diseases much faster and offer methods of treatment to prevent mortality. But then there is the question of would you want to know as a patient, especially if the disease detected is something like Alzheimer’s, which has no cure. I think about the “In the Family” movie we watched in class and how the main character was overwhelmed and completely obsessed with the idea that she had a gene which could lead to cancer. I think once you realized you had a gene for a disease that couldn’t be cured or treated, you would live a completely different life, one in fear rather than enjoying every day.
Lastly, I think there would be serious implications for the government. The US health care system is going in a downward spiral and as a nation, we are attempting to bring it back. Throwing in the $1000 genome would bring up so many more issues and further complicate the problem. There would be questions of ethics, insurance policies, income, credibility, and morals. While the $1000 genome is a giant leap in a positive direction, it may be too much to handle for right now.
The $1,000 genome sequence is possible. However, as this article as well as Cancer, Data and the Fallacy of the $1,000 Genome both emphasize that sequencing a genome and utilizing the information are two completely different things that bear two very different price tags. While sequencing costs continue to come down, there are other cost concerns coming into play. Storage is becoming expensive especially on the corporate level. While a sing genome sequence (only the raw data) could be stored on an inexpensive DVD, the volume of data that is being collected in research labs and corporations is huge and requires in-house data centers.
ReplyDeleteThe bigger issue at hand is that for any of the information sequence to be of use, it must be analyzed and interpreted by a professional in the field. An incorrect interpretation could leave a patient believing they are destined for an early death when in actuality they are fine. The analysis and interpretation is the expensive part. This could cost upwards of 25K to 100K.
Some people would like to think that this technology could allow them to demand a genome sequence from their doctor if they have been diagnosed with cancer to better decide on the exact treatment they will pursue. The fallacy in this is that even if they could get their genome sequenced for $1,000 (and most likely without the aid of insurance), to have any efficiency in treating their cancer they would have to get their genome sequenced and a health genome sequenced. Additionally, someone would have to compare the data to learn how to treat the cancer. Additional sequences would have to be done throughout the course of treatment to see if the treatment is working, if the tumor is spreading, and how treatment will have to be adjusted to be effective. Obviously, the costs of such monitoring would add up quickly. Without insurance supplementing the cost, this treatment course is not feasible.
I think that the $1000 genome is probably going to cause more problems than benefits, at least at this point in time. The article states that this is targeted to scientists and other wealthy people. On a public health level, the fact that rich people can access their genome sequence is not going to change anything because those with a lower socioeconomic status will not have access to that kind of information. Another thing is that having the sequence to your genome means nothing unless you have the analysis to go with it, which is much more expensive so again, only certain people will have access to that information. It also brings the issue of confidentiality and storage. How are such huge files going to be stored and kept safe? It is going to cost too much money to find out that you maybe don’t have a disease or that you do have a disease but there’s no treatment for it, or luckily some people will find out that there is treatment available for whatever condition they may have. But, someone that doesn't have a lot of money may not take that chance, which will increase the disparity in health care.
ReplyDeleteAnother important point that the article brought up is that it can cause issues with amateur scientists trying to interpret the genome. If the genome is misinterpreted, there can be misdiagnosis and obviously incorrect treatments and so on, which in turn, may create more health problems. I agree that the public is probably not educated enough for this type of technology. It sounds great to be able to know about diseases you are predisposed to and the treatments available for it, but at the same time, we may not always know what to do with that information. That in itself, can negatively impact public health and medical professionals who will be inundated with questions that they may or may not be able to answer. Another issue is that with every innovation come new policies. So, new policies need to be created and worked on in order to ensure that people’s privacy is protected and what the use of this sequencing is going to be. Creating these policies might be tricky since it will involve the interest of many players: insurance companies, employers, patients, pharmaceutical companies, etc. Different entities may want access to this information for different reasons and so, it might be tough to come up with a way to regulate this kind of technology.
With the 1,000 dollar genome sequence becoming more popular and widely accepted, I think we have to also take a step back and be cautious with some intentions of the screening. While it helps doctors determine dosages and genetic predispositions to diseases such as cancer, some people might view the idea as a sort of violation of nature. That our genetic make up sets our course in life. I wouldn't personally be opposed to participating in the genome screening because of my own family history of cancer and heart disease. Some people want to know for peace of mind or to take precautionary measures to ensure their own risk is minimized. At the rate the cost of genome sequencing is declining, it seems that it will become affordable to most middle class families in the near future, and with the help of medical insurance coverage, it could be even sooner.
ReplyDeleteThe idea of putting a price tag on genome sequence is already an uncomfortable prospect in my opinion. It opens doors for the greedy billion dollar industries that run the health markets today: insurance & pharmaceutical companies. The fact that the $1'000 does not include any sort of analysis is completely ridiculous. $1'000 is a lot of money for a lot of people and this "deal" leaves the door open for thousands more to be charged depending on what kind of analysis can be done with that information. Much like the Myriad genetic test, this whole concept seems to be another way the health industry is looking to "make a buck." If we can sequence everyones genome and thus, cure disease and improve quality of life, everyone should have this opportunity. Although I can appreciate that Steve Jobs paid $100'000 for his genome and now the price tag is dwindling down to $1'000, I still this this "product" is geared towards the wealthy; this will cause yet again another health disparity in public health.
ReplyDeleteI do not mean to undermine what has been accomplished: it is both fantastic & exciting to witness new technology becoming more and more available. However, this is unchartered territory especially when dealing with the masses. With new technology & clients comes more and more opportunity for problems. If it will become available to everyone, then everyone must be educated on what it means to their personal health. To what extent does sequencing someone's genome increase their likelihood of survival? If Steve Jobs is any indication, than regardless of how many analysis you can afford, there are no guarantees in this process. So, although I admire what has been accomplished in the field of genomics and although I see how this has great potential, people have to realize that this could mean a lot more fuel is being added to the fire that is the American health industry: so can they, and will they, handle it?
I disagree with my classmate, Erica Cuevas. I strongly believe that the $1,000 genome would benefit those who sought it out for themselves. I agree, that it would be overload to suggest that it be part of regular medical procedure, but those individuals who go out of their way to pay the extra money have a much stronger reason to do so than just having free time and money on their hands. Those specific people who choose to have such a procedure done will often have a family history of a genetic disease, giving them every rational reason to test themselves.
ReplyDeleteI think it is ignorant to say that it would be pointless to know you have a gene for a disease that there is no cure for because there are always things you can do to lessen the possibility or severity of the onset of such a disease. The article uses the example of Alzheimers, and a perfect example of prevention would be to do word puzzles or activities that stimulate your mind, possibly lessening the severity of the symptoms you would've had otherwise.
As far as the structure of governmental policies and methods of medical professionals, I don't think much would change to protect the privacy of those individuals. We already have HIPAA and as if that wasn't enough, GINA goes even further to prevent discrimination and prohibit the requirement of genetic testing by any insurer or employer. As a result, I predict that only good can come out of this advancement and any faults that arise are on the fault of the individual who decided to undergo their own genome translation.
I think that the layperson’s understanding of the data retrieved from human genome sequencing is not sufficient enough for sequencing to significantly benefit the population as a whole. If everyone in the United States had their genome sequenced, a lot of unnecessary chaos and anxiety would exist amongst the US population. What many people in the population would struggle to understand is that just because they have a gene for a disease, that does not mean that they will definitely develop the disease, it just means that they have an increased risk for developing that disease. While it could be beneficial for individuals to have their genome sequenced so that they could begin practicing prevention behaviors, it would also cause a lot of anxiety and turmoil for individuals who have the gene for un-curable and unpreventable diseases like Alzheimer’s. Additionally, there are a lot of ethical issues involved in genome sequencing that I do not think that the government is prepared to deal with just yet. Who determines whether or not an individual should be told that they have a gene that significantly increases their risk of developing an un-curable disease? If a genome sequencing analyst does not believe that it is in the individual’s best interest to give them this information, then the individual could eventually sue the analyst when he or she develops this disease. I think that the ability for human genome sequencing to occur is a great discovery in medical technology. On the other hand, a lot of education regarding the results of human genome sequencing amongst individuals in society has to occur before it can become a regularly used resource.
ReplyDelete$1000 genome sequencing is perhaps an impressive step forward for members of the scientific community, but as the article mentions, the rest of the world may not be prepared for it. Although cheaper means more accessible, there are a variety of other factors that go into getting a genome sequenced and then understanding what this sequencing means. The past two articles we have read mention the strong disconnect between health care providers and their ability to convey appropriate knowledge and advice to the patient. Just because this test is here, does not mean that these physicians are now prepared to help interpret results or advise their patients on these steps forward. I think there needs to be quite a large movement of ongoing education type workshops for physicians, so that they can accurately help their patients. In addition, genome processing is accelerating and improving, but government policy and procedure is not. What happens to all the data stored in the processing center if the lab shuts down? Or if the servers get hacked? Do you have to pay out of pocket if you have no family history of certain diseases, but get subsidized by the government or your health insurance if you do? Can this be considered preventative medicine (a pillar of public health practice) and if so, what does that mean for public health officials, in ministries and boards of health? There are many questions to be answered, and everyone else is moving much more slowly than the science in the labs.
ReplyDeleteOn a different note, although health and medicine do not technically operate in a free market, different labs competing to sequence entire genomes will most likely bring costs down as we move forward (as evidenced by the one lab offering $100 sequencing). Even though Myriad holds a patent for BRCA1/2 sequencing, this could perhaps push them to lower costs, since they only sequence one segment of the genome, can they reasonably charge $3000 when other labs will complete the entire genome for 200% less? It may be the impetus necessary to start bringing down the price.
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As the article mentions, science and technology is ready for the $1000 genome but physicians, the government, and general public are not. In terms of public health, I think it will be very beneficial in targeting how to prevent diseases. If, for example, a population is sequenced and found to have a higher percentage of getting type II diabetes, then as public health scientists, we can target that population and educate them as to how they can lower their chances with certain preventative measures.
ReplyDeleteThe government and general public, however, are not quite ready for this and may not benefit from this technology right now. If a person pays $1000 and finds that he/she has a 90% chance of developing Alzheimer's disease, for example, the emotional and psychosocial effects of finding out this information would be far more burdensome. Sequencing someone's genome is also a privacy of his/her rights and this may cause issues with the government and HIPAA or GINA. Where would a company such as 23andme draw the line as to how much information they can keep and share? Does this information get filed for later use? Using the $1000 can lead to all sorts of issues such as insurance policies and privacy rights. If these issues are addressed, I believe that this technology will really benefit everyone and will be a tremendous advancement for public health.
With genome testing becoming more accessible and less expensive, it could have many affects on the public. I do not know if it would necessarily benefit patients if it was incorporated into health care, such as primary care. I only see the benefit of the test for people who are at risk for a mutation, or like the article mentioned someone with cancer or other conditions, like Steve Jobs. For those who are at average risk, it seems unnecessary and would just cause more emotional harm than good. Therefore, I don't think there should be a policy incorporating them into health care, but should be based on the individual's choice. In addition, if the government makes policies or places control surrounding that, it questions how private the results would be and who would be able to access them.
ReplyDeleteJamie Shaw
ReplyDeleteI agree that this advancement is great, and fabulous for technology and scientists. However, I do not feel that this advancement in technology, allowing the general population to be able to screen their entire genome for only $1,000.00 is appropriate at this time. I think that the general population does not have the knowledge to take this kind of information (with no analysis) in a positive direction. People will just see their mutations and suddenly begin to investigate this on the internet, where incorrect sources are abound. They will create their version of what they believe they have, and bring it to their doctors. It may not even be correct! They will ask millions of questions to these physicians and the doctors may not have the answers, or the answers that the patients want, so patients will feel frustrated, and physicians will feel that they need to prescribe a certain medication or path of treatment that they may not have prescribed, just to keep the patient happy.
This also presents issues with confidentiality and where to keep this information. These files, while not huge on their own, will eventually take up tons of room, with many people getting their genomes sequenced. This presents potential security breach issues, and then issues with who got the information and where they may send it. The police and government are not ready to handle problems of this magnitude.
I think that this is a wonderful advancement. If people can be educated, and not barrage their physicians with treatments and questions (there could be potential for an analysis service, and counselors) AND the government can create a plan to keep this information secure, this could be applicable to the real world, but for now it definitely is not.
I can see so many potential benefits that more affordable genome sequences can bring, especially with regards to personalized medicine. Health providers will be able to prescribe medicine that is appropriate for their genes and help prepare patients with genes that cause debilitating illnesses for the future. In addition, it will allow families to plan for having more kids and figure out risk assessments of passing down heritable autosomal illnesses. The possibilities seem to be endless.
ReplyDeleteI absolutely agree with Jamie Lynn's view that despite the potential benefits of personalized medicine due to more affordable whole-genome sequencing, the general public, the medical/public health community, and the government may not be ready for this type of technology. The article mentions that poor analysis and interpretation of the results may lead to undesirable consequences. Health care providers, including physicians, have to be retrained in order to incorporate genome sequencing technology into their every day practice. It will take a lot of time and effort in order to fully and accurately incorporate this into their practice, but at the moment most physicians' time are constrained by the rising demand of patients.
In addition, like Jamie Lynn said, knowing more may not necessarily be better. If we received an ambiguous analysis of our genome with a result like, "You have 50% chance of Huntington's disease", it would still make an enormous impact on our lives, although it doesn't say 100%. It will always be in the back of our minds that we have a 50% chance of developing Huntington's later on in life - thus hampering upon our quality of life. Getting results and analysis of all the potential diseases we may get will force us to plan for the future, rather than live and enjoy life in the present moment. I do not believe any one of us is ready to receive information like that.
Lastly, we must consider who will be the owners of our genetic information. How much power will we have in order to keep our genetic information safe from companies and institutions that may misuse our genetic information? Security issues are crucial with increasing levels of data sharing/transferring and the possibility of cyberwarfare, which may impact all of those who choose to have their genome sequenced.
The most important line in this entire article is the closing sentence. "Bottom line is, scientists are ready for the $1000 genome, but the governments, the medical system, doctors, and the general public are almost certainly not," this is the biggest issue that genome sequencing and testing will face. The genome sequencing has such amazing potential but with one bad public relations incident the entire project could be set back or doomed. People are not quick to trust new science and they are not quick to forgive it. Government and science would need to work together to make sure that there was regulation and standards and qualifications set before any of this could be readily given to the public. One scam or one consumer company that makes a mistake that makes headlines would bring scrutiny and skepticism on all of the legitimate services. There shouldn't be a rush to lower the cost until the entire procedure has become safe and trustworthy in the eyes of professionals and the government. With so much benefit that could come from inexpensive genome testing and sequencing it would be tragic to watch it all fall apart from a careless mistake.
ReplyDeleteI think this article ties in directly with many of the questions we ask in our class. We like to think about all of the positive impacts this can have on our lives, but along with these great scientific advances come some negatives. On the positive side, if genome sequencing becomes this cheap, many lives could be saved and illnesses prevented. We would be able to discover mutations such as the BRCA gene much easier, and can then take the necessary steps to prevent the cancer from developing at all or to a more advanced stage. This could also be very beneficial to the population as a whole, as we can use the mapped genomes to identify more areas of concern that are related with other diseases. The further that science advances, the more mutations we can discover and attribute them to different health outcomes. This information can then be used to save more lives. However, on the negative side, we have to consider the issues we so often bring up in class. Who will have access to this information? Will the people who get their genomes mapped have counseling offered to them? What kind of information will the report include? Could this be used against them? These are all things to consider before putting this test out to the open.
ReplyDeleteI thought it was surprising how a genome that comes not analyzed is $1,000 and a genome that comes with as little as 0.02% of it analyzed costs $3,000 more. For sequencing targeted areas such as cancer, I can't help but ask myself if I would want to pay for that analysis, or even the sequencing at all. I feel that as the price keeps decreasing, the scenario becomes less and less hypothetical for average people. For that reason, it must be the same for the public health world and medical professionals. Public health and governmental agencies will definitely have to come up with new policies regarding the human genome and access to it. Researchers and medical professionals must keep wanting to move forward and coming up with new discoveries based on the human genome.
ReplyDeleteAlexandra Kramer
ReplyDeleteAlthough it makes sense, it actually didn't occur to me that we have been scanning for our entire genome, when in fact we are only different in 0.1%. This is something that I think we should pay more attention to and try and cut down so that the process is cheaper. The fact that it is $1,000 without analysis is great, however still not quite accessible because the analysis part is what is crucial. People will have no idea what the results mean unless they have someone analyze them.
The last sentence of the article is key. It doesn't do society any good if only one part of the equation is progressing. If the other parts are not keeping up, then not much can be done to make positive changes. Everything has to change as a whole so that each part compliments the others. All these scientific breakthroughs are great and should continue to be discovered, however we should also put more focus on how we will deal with them.
That being said, it is really great that scientists are discovering ways of making the genetic testing so much cheaper. This is something that is actually relative to most people's lives, so the more accessible the better. We just need to remember that genetic testing shouldn't rule our lives. We can still focus on other aspects of life other than what is going to possibly happen years down the line. It's hard not to get caught up in the outcome, but as the testing becomes more common we have to remember to also focus on our lives in the present moment.
With the cost of genome sequencing dropping to around $1000, I think that people will be more prone to get the test done. Most people like knowing their probability of developing a disease in the future and will definitely use this low cost as an advantage. From a public health perspective, we will need education programs to warn people about the benefits and disadvantages of genome sequencing. Making people more aware of their options is important. This lower cost will also have an effect on medical professionals. Doctors will probably be getting more patients who want to order the test and genetic counselors will play a much bigger role in revealing test results and helping patients choose whether or not to get tested and counsel them based on their decisions and results. Insurance companies will also be affected, in that they will probably have to shift to covering at least a percentage of the testing. I’m not sure how the low cost of genetic sequencing will affect the government policies that are already in place. Overall I think this is a huge advancement and will be beneficial in the health field.
ReplyDeleteThe $1,000 genome would definitely be beneficial in the medical community. With such a low cost it would be much more accessible to patients and would therefore lead to better diagnoses and treatments. It could possibly become part of standard care so that patients are more aware of what they are dealing with and better ways to make decisions with that knowledge. However, it would also create some previously unmet problems as well. There is the issue of storing everyone's genetic information and who would have access to that information. New laws and policies would have to be put into place in order to protect people's private information. There would have to be effects in place to ensure the safety of the information. With the test being more accessible to patients this might create problems for medical professionals as well. With such an abundance of knowledge they may be presented with more information than they can handle and see a number of genetic predispositions that could possibly never come to fruition. Would the medical professionals have to try and prevent all of the genetic predispositions that come up in the testing? It will be interesting to see how these problems will be dealt with. However, I do not think this is a problem of the near future because the testing that can be done as of now for $1,000 only covers an extremely small percentage of a person's genome.
ReplyDeleteIn terms of the $1000 genome test, it is absolutely vital to incorporate new advances in science and health into our world if there is a chance they could give us a healthier and longer life. However, this is only if it fits in with the times we are currently facing, and this type of test may only lead to more drug costs and new types of medication for those who have already fallen into the numerous traps of drug companies. The article concludes by saying that we as a society ay be ready for this $1000 genome, "but the governments, the medical system, doctors, and the general public are almost certainly not." This is absolutely correct as we are already having much trouble with our health care system. Introducing this $1000 genome may only lead to people wanting some of that cost covered by insurance companies, therefore making their already high premiums even higher. It is absolutely something that is necessary to think about, but we may fall victim to our own success if we do not introduce this new test with caution for very good reason, both financially and to give the government enough time to adjust.
ReplyDeleteThe $1000 genome will certainly have many impacts on public health, medical professionals and governmental policies. Many of these impacts may not even be able to be predicted. The article mentions that people will be able to find out their risk levels for certain conditions, such as Alzheimer’s. This will certainly change the way the medical field works. If many more people know their risk of certain diseases, doctors will need to know how to handle this. In class we discussed companies like 23andme. These companies do cheap genome sequencing but as we also discussed in class this can lead to other issues, such as who will interpret the results and what are the ramifications of people getting misleading or false results. Additionally, will GINA cover people getting their genome sequenced? These are all things that should be considered and as the article mentioned, although the science world may be ready for this change, the general public and government may not be. However, with enough planning, having genome sequencing become a more standard thing can have its benefits.
ReplyDeleteThe $1000 genome sequencing has beneficial and harmful side effects. It is difficult to put a price tag on identifying what specific genes we each possess. To me this seems very expensive seeing as it does not include interpretation or advice. All you get is the results of what genes you have but no idea what it means. Using outside services to obtain your gene sequence and then bringing it to a professional to interpret can cause misinterpretation by someone outside of the lab who conducted the test. This can in turn lead to misdiagnosis and unnecessary pain. People who are likely to seek out a genome sequencing test and medical advice may be more educated or already have a genetic susceptibility that makes them more at risk. Wealthy people may be the only people that can afford this test at this time. People who can pay for the test may also be more likely to be able to pay to alter the genome or to change the genotype of their offspring for more desirable traits. Overall, this could widen the gap in health disparities within the US and also worldwide. Countries that are not wealthy or as technologically advanced may not be able to afford or conduct these tests and therefore will not have access to such information, contributing to increased health inequalities.
ReplyDeleteThe workload for medical professionals will increase if everyone decides to use outside companies to sequence their genome. This is because the results do not come with an interpretation and most people will need to see a physician in order to make sense of the results they receive and to obtain advice. Government policies will have to change with these advancements as well in order to keep up with the privacy issues that will come about with universal use of such tests. Officials will also need to find a way to make this accessible to people of different status and income. Such issues need to be addressed in order for this test to be accessible and realistic
On the other hand, genome sequencing may in fact be worth the price. We could all benefit in some way from having our primary care order a genome sequence to figure out if we have any susceptibilities to disease. It would be great if this were possible, however as of right now people have to pay out of pocket for an outside laboratory to sequence their genome and then go to a physician separately to have the results interpreted. Making this test covered my insurance and also a part of everyone’s primary care visit would be convenient and cost-effective. But it is not that easy to make this possible. If this were to happen in the future, or through going through outside labs, one can sequence their genome and identify any susceptibilities or abnormalities. We could then consider measures in order to prevent a disease or illness. However, there is the question of whether or not we want to know if we have a mutation for an untreatable or unpreventable disease such as Huntington’s. I believe this decision depends on the person and that is why this test is voluntary and patients should be warned to the possibility of such results. Even though we may not be able to cure or prevent such illnesses, we could possibly learn of ways to decrease the severity, prolong the onset, or simply affect the way in which the person wants to live their life. The possible positive and negative aspects need to be considered. This test needs to be made even cheaper in order to be accessible to all people who make the decision that they want to sequence their genome. However could identifying each of our susceptibilities lead down a slippery slope to a future superhuman population free of all disease and illnesses?
THe $1000 genome definitely will have an impact on public health, medical professionals, and government policies.
ReplyDeleteFor public health, I think the biggest impact would be this would really help to increase primary preventive measures or prophylactic prevention measures. By being able to predict someone's chances of developing a disease, people can have a head start in changing their lifestyle so that they might decrease the risk factors for that disease or slow down the process of that disease from developing. And not only would public health be able to help prevent diseases from spreading on an individual level, it can look into communities as well. You can start to look into see which group people have which genes that are more likely to develop a certain disease or which group more distinctly have this certain gene. And from there, people in public health can look at why does that particular group of people have this gene more than other groups; is it their environment, their lifestyle, what risk factors are the cause of this. By making genome sequencing cheaper, and allowing people to get their genome sequence more easily, it really increases research, such that public health professionals are able to look at if there is an association between a group of people who are diseased and their genomes.
For medical professionals, the $1000 can also help them predict if their patient will have a disease or not and they can make more recommendations to their patients based on the genome sequencing. Patients might also be more willing to change their lifestyle if they are told that due to their genetic makeup their probability of a certain disease is so and so.
For the government, they would have to create more laws and policies around genome sequencing programs. Due to it being so much cheaper now and some companies saying they can sequence it for even just $100 and all the direct to consumer websites that offer genome sequencing, its hard to tell whether the information we get from cheaper programs are more accurate. The government will have to step in to make sure that the procedures and information these places are giving out are accurate and trustworthy because the negative thing about getting your genome sequenced is the reveal of being diagnosed with something terrible. And if it is actually incorrect, this will cause the patient to be in endless emotional possibilities and they might start to consult their doctors and then try to get tested for the disease and when the test comes back negative, the patient might not believe it, and it just makes everything complicated and unnecessary, just because the information those consumer sites were giving was not accurate.
Overall, the $1000 genome seems great because it allows people to get their genome sequenced so much easier, but at the same time, this won't cover the analysis of the genome, which does make it slightly useless in my opinion, unless you want to pay for the analysis or the person him or herself knows how to interpret the data they receive back. Also, I agree very much that "scientists are read for the $1000 genome, but the governments, the medical system, doctors, and the general public are almost certainly not" because by creating a business out of this, it causes quality of work to change, doctors and patients to have to worry about this quality of data too, and in general, some people just might not want to know everything about themselves, to the point that they can predict whether they might develop Alzheimer's or not.
This is definitely great that genome sequencing can be as cheap as $1000 and it can have positive impacts, for public health and the general population, but at the same time, I don't know whether the general public would really actually pay $1000 just to get it sequenced, and not analyzed.
I think the $1000 genome is a great start to using genomic sequencing for more preventative measures. Some people like to know what their risks of getting certain diseases will be and this makes it more affordable for them. The problem is the additional cost of actually having the sequence analyzed. On a personal level I would not want to know all the diseases or illnesses I am likely to get, even with my doctor being able to personalize prescriptions and give me preventative care. There are some diseases that can't be prevented, Alzheimer's, so why should I know I'm probably going to get it. People like me will not want the genomic sequencing done, so that section of the population will not partake in public health studies which can change the outcomes of the studies, making them less reliable.
ReplyDeleteGovernment policies GINA are already in place to protect people from discrimination due to genetic predispositions to certain disease. Unfortunately, there is not a government policy or act that decides what will happen to your genetic sample once it is sequenced or what happens if a company or medical professional misinterprets the sequence. Without those regulations, people may not feel protected when they give their genetic sample to a laboratory or what happens if the sequence is analyzed incorrectly.
Medical professionals are already aware of genetic testing, but do not usually refer patients to do it. If an insurance company does not cover the test, most people will not be able to afford to pay for it. Once medical professionals feel comfortable with referring patients and patients can afford the test, analysis of the sequence will help them give patients the preventative care and prescriptions that will lead to a more personalized and better healthcare system.
The ability to have your genome sequenced for $1000 will have pros and cons at every level. The obvious pro is being able to treat diseases or potential diseases on an individual scale. The cost of the test itself might go down for the consumer (will insurance one day cover the cost?), but the training required for medical professionals will definitely be costly. I wonder if doctors will be able to ask their patients, “would you like to have these 3 tests done or just go ahead and have your whole genome sequenced so we can know everything?” I think the most difficulty will be seen in government policies trying to control the usage of the information as well as the privacy. Even though the scientific technology is there, it will take a long time for this testing to become common practice. This is the same with any new medical test, but one medical test can only tell you so much about someone… having your whole genome sequenced and having that information paper or stored in a computer is a big risk. If someone hacked into a computer or found the paper, they have access to much more personal information than was ever possible in the past. I think that people could still gain access to personal information even with governmental policies in place. Isn’t it easy enough to steal someone’s identity now? Easy enough to hack into a secure file? People will always find a way around rules and regulations. I feel like getting your genome sequenced should almost have a disclaimer like “swim at your own risk” when there’s no lifeguard on duty.
ReplyDeleteI think that the outcomes of the $1000 genome will be two-fold. People who were unable to obtain this information at the higher cost will now have endless possibilities regarding knowledge about their complete genetic make up. I think that in the cases where people might have serious diseases, this will be a great opportunity for them to seek medical attention and possibly prevent the adverse effects of the specific disease. Doctors could prescribe medications, people could make better lifestyle choices knowing that given factors will increase their likelihood for getting a disease, and they could help family members prevent or ameliorate illnesses that they might also be at risk for. On the other hand, people might be faced with emotional and psychological effects from knowing they are at risk for or have a gene for a specific disease that they might not otherwise have experienced. Personally, I would prefer to live without knowing that I have a gene for a disease or that I am at risk for something because I think that I would live every day with fear. This disease or mutation that might lead to a disease would always be at the back of my mind. I think that the ability to sequence people's genomes would be beneficial for the preventive measures of public health, but I think that there are many consequences that have the potential to arise if more and more people can obtain their genome sequence and I am not entirely confident that government officials, healthcare workers, or society as a whole are prepared to deal with the possible consequences.
ReplyDeleteWith our increased technology in public health, fragile health system, and concerned government, this $1000 genome can make a large impact. In public health, this relatively cheap genome sequence can impact communities where a risk to a certain disease is really high and preventative measures can be taken to protect the community or to look at epigenetic factors in order for their specific high risk gene to not be expressed.
ReplyDeleteFor medical professionals, this $1000 can affect them because direct to consumer companies like 23andme or direct labs can make connections with certain medical professionals to increase their use of services. For example, pharmacy companies have a similar connection where some health care centers refer their patients to a certain pharmacy, Because the sequencing of the genome is more accessible, more companies can arise to advertise their sequencing services and compete in the market for their connections with medical professionals. Medical professionals will have a powerful role in whether or not their patients will get their genome sequenced because patients believe that their doctors or more knowledgeable about their health.
For governmental issues, the insurance companies will definitely have their foot in the White House door to make sure that they will have access to the people's genome sequence if they decide to get it sequenced. This is because of a theory called adverse selection which is the tendency that sicker people are more likely to get insurance. With the relatively cheap service, people can get their genome sequenced and if they find out that they are more likely to get sick, then they will sign up for insurance (insurance companies will lose profit) and vice versa where people who find out that they have less chance of getting sick will not want to pay or sign up for insurance (insurance will again lose profit). In our readings we learned about the Health Insurance Portability and Accountability Act which protects people's privacy from health insurance companies, who will raise premiums if the person is seen to have a high risk in their health. This policy may change because with the genome sequence, the insurance companies will not be able to stay in the market if they are not informed.
With the cost of genome sequencing at 1000 USD I believe that the test will become a common luxury for those who might not necessarily need it but can afford it, and an expensive but manageable option for those who are at high risk. With that said, because genetic information will be so readily available at an affordable (relative to a price of a couple thousand US dollars) price a new door will be opened. This is the door to positively selecting, or rejecting, traits in one's offspring. Medically speaking, use of the 1000 USD genome by medical professionals will increase in screening and treatment of patients but also in research settings. As researchers gain access to increasing numbers of genomes to study they may begin to uncover trends and consequently come to understand human diseases more and hopefully develop treatments and cures. In regards to the government, I envision an increased role of government in genetic testing. I believe that they will interject in regulating the administration of the tests as well as licensure to give such tests and the storage of the test results.
ReplyDeleteFirst of all, I think it is exciting that the cost of genome sequencing is coming down to a more reasonable level. I think that this technology could be incorporated into our medical system if it was more affordable and potentially help many people. But I agree with the article in the sense that I do not think we are ready yet for a tangible genome sequencing procedure for all. While the GINA act is a step in the right direction with privacy and autonomy over one's DNA, there is still fear in the public over who would have access to their genome and how it could potentially be harmful for them to know their genome, such as the case with life insurance. I also do not know where our medical system is at and how apt they would be to deal with taking one's genes into account when trying to decide on a course of treatment for a patient. It does seem like the government, public, and medical system need to embrace genetics a bit more before we can really reap the benefits of an affordable genome sequencing procedure.
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ReplyDeleteThe article hits the nail on the head when it says: “scientists are ready for the $1000 genome, but the governments, the medical system, doctors, and the general public are almost certainly not.” $1000 genome sequencing is both elitist and a superficial science-fiction fantasy. It is elitist because only those who know about it and those who can afford the cost of sequencing and analysis will have the option of this service. It is not a service that will be available to the general public. It will only be another item on the long list of specialized medical services that the United States has to offer for those who can afford it.
Even if genetic sequencing cost zero dollars and it was automatically given to everyone in the United States, it still would be something without major impact because, as the article says, there are not the resources in place to help people make the information from genetic sequencing valuable. There are too many unanswered questions and there is a great lack of safeguards. For example, one cannot be sure that the genetic sequencing company is giving reliable results. Even if the results are precise, one cannot be sure that the interpretation is accurate. Even if the results are interpreted perfectly, most statistical analysis includes a p-value of less than 0.05. Even if the results are interpreted to a statistical significance of P < 0.001, there is still a 1 in 1000 chance in being wrong. I predict that once the allure of “$1000 genome sequencing” wears off, people will realize that this is a scientific fad and it is not quite ready for public use. Some people who can afford to spend $1000 and then some on genetic sequencing and analysis will have this done because it will make them feel like they are receiving a service once only available for celebrities such as Steve Jobs and Ozzie Osborne. After the new-car scent fades, people will realize that genome sequencing is not really that useful to them yet. Unfortunately, before people make this realization, there will be a lot of confusion, misinformation, and incorrectly answered questions.
Obviously a personalized genome sequencing for $1000 is a great bargain, but we cannot condone the impact that this will have on public health, medical systems, the government and health professionals. I think this should be processed and filtered through a set of regulations. It is much similar to what we have discussed in class with the Wilson and Jungner criteria and making sure that once possible medical interventions are discovered by scientists, we have to make sure the action taken during a medical treatment are effective and ethical for patients. I think that this article clearly states that science has advanced with genome sequencing, but the clinics are not yet up to speed for this treatment to be completely meshed into the medical system. For this intervention to be intiated in the future of public health, it would significantly improve community health by intervening with possible prediagnosis of patients in order to prevent diseases from even ever occuring. For medical professionals, this would increase there workload because many of the genome sequencing companies will send the patient the sequencing, but not intrept there results of the test, so patients will have to seek out advice and counseling from doctors. As for the government and the medical system dealing with an already complicated economy, it would become a fight for who can afford the sequencing and which health care plans include it. In the end, our society is not ready for such a cheap genome sequencing, but in the future with a stable economy and more medical professionals on board with the effectiveness and preventive influence genome sequencing can have on medicine.
ReplyDeleteObviously a personalized genome sequencing for $1000 is a great bargain, but we cannot condone the impact that this will have on public health, medical systems, the government and health professionals. I think this should be processed and filtered through a set of regulations. It is much similar to what we have discussed in class with the Wilson and Jungner criteria and making sure that once possible medical interventions are discovered by scientists, we have to make sure the action taken during a medical treatment are effective and ethical for patients. I think that this article clearly states that science has advanced with genome sequencing, but the clinics are not yet up to speed for this treatment to be completely meshed into the medical system. For this intervention to be intiated in the future of public health, it would significantly improve community health by intervening with possible prediagnosis of patients in order to prevent diseases from even ever occuring. For medical professionals, this would increase there workload because many of the genome sequencing companies will send the patient the sequencing, but not intrept there results of the test, so patients will have to seek out advice and counseling from doctors. As for the government and the medical system dealing with an already complicated economy, it would become a fight for who can afford the sequencing and which health care plans include it. In the end, our society is not ready for such a cheap genome sequencing, but in the future with a stable economy and more medical professionals on board with the effectiveness and preventive influence genome sequencing can have on medicine.
ReplyDeleteThe thousand dollar genome I think will have an overall negative effect on the Healthcare system and those involved with in it. Starting with the general population and lay people outside of the medical and health field who are considering getting their entire genome sequenced, there is a lack of infrastructure to support the information that will be presented to those who do obtain it. As mentioned in the article the labs aren't the ones provided the geneticists that can interpret the information for you. It takes the individual to find geneticists that can interpret their information and each one my have their own biases in interpreting information.
ReplyDeleteThe massive amounts of information that is derived from the genome sequence itself is stored in a cloud storage system and an issue with that would be the level of privacy that is expected and who has access to all the genomic information. There seems to be a lack of consensus on whether the genome is relevant to get sequence because 99.9% is identical in most human beings. It seems wasteful to have the entirety of it and only need the information from the 0.1%. Overall I think there needs to be a lot of work in order to be able to be prepared to receive the influx of information that cheap genomic sequencing can provide. The validity and utility of these tests have to be properly evaluated.
I think we are definitely getting ahead of ourselves with this $1,000 genome. The article concludes that the scientific community has the capabilities to produce an entire genome sequence for that cost, but the rest of society is not ready to handle the consequences of this product, and I completely agree. Especially with something this involved, we must make sure that there are certain procedures in place to manage what comes as a result of giving the general public access to their genomes. The ability to do this is inarguably extraordinary, and has wonderful potential in the field of health care: it will allow providers to give more individualized and specialized care to patients, thus eliminating a lot of guesswork in treatment programs, and will help people make educated life decisions. That being said, we must also consider the damaging affects that will come about if society is not prepared. Ethical questions must be asked an answered, support lines must be provided, and analysts and people who can interpret the genetic information must be accessible. Security issues must be addressed, property and ownership protocol established, and decisions regarding consent must be made. Possibilities of discrimination, inequalities, and disparities must also be considered.
ReplyDeleteI worry that we are jumping into this too quickly, and in our eagerness to explore these new possibilities we are not looking farther than the next step. I think at this point, the results would be more disastrous than helpful.
With anything that surfaces in the medical world there are always pros and cons. The ability to map a persons genome for 1000 dollars is no different. I think that on one hand it could be revolutionary for healthcare; people would be able to get there genome mapped, then act early with preventative measures and act proactively if there are any mutations that will cause illness down the road. The other thing, as mentioned in the article is that patients could have their medical plans (i.e. prescription drugs) and care tailored to fit their specific needs. I think the U.S. Healthcare system could benefit tremendously from this, not only would the quality of care increase (tailored medical plans), but i also think that preventative health measures would increase, something that the U.S. has been struggling with for years. Not to mention that if the government wanted to tax these tests, there could be a new revenue source.
ReplyDeleteI think this test wanders into hazy territory is around the matter of moral hazard, i believe that because these tests are so available to the public, when they receive negative (i.e. you will have cancer and die) findings and are not educated and counseled on what they mean people may act irrationally. People may act out and begin to not care what they do; maybe putting other people in harms way, even committing crimes, knowing that they will not have to face the consequences. I believe that there needs to be proper education around this test, or you could have a situation where the government needs to deal with an increased rate of crime, or other related issues.
I believe that overall there needs to be a structured way to distribute findings so that people can make educated decisions other than irrational ones after they receive their test results. If this doesn't happen i dont think it will be good for society as a whole.
I think the effects of the $1,000 genome will be quite fascinating, but only for those who can afford it. Although sequencing will cost around $1,000, the most important part is the analysis which could end up costing tens of thousands of dollars. Unless the price of analyzing the sequenced genome begins to decrease, only a small percentage of individuals will be affected. However, for those able to make the pricey purchase, especially those with a family history of disease/cancer, they will feel more inclined to order the genome sequencing/analysis before having kids, getting prescribed major medications, etc. This $1000 genome will put more stress on health professionals, as making an incorrect analysis will most likely have severe side affects on the patient. Also, the government will probably feel pressured by the public to somehow help cover the cost of sequencing/analysis through insurance, etc. Overall, the whole aspect of $1,000 genome sequencing is pretty awesome, but of little value without the expensive analysis.
ReplyDeleteI think that the $1,000 genome is going to have a large impact on public health, medical professionals, and governmental policies. When people are given access to these things for a relatively inexpensive price, I have no doubt they will take advantage. It can be helpful for many reasons. The article suggests that people will be able to know themselves better which can be very helpful in terms of disease prevention and treatment.
ReplyDeleteA part of me also thinks that the $1,000 genomes is a way for us to feel like we can truly take control over everything that happens to us. We want too much control, with gene altering and sequencing.
I think that having the knowledge of what you are prone to develop can be helpful but also intimidating. As seen in the documentary, “In The Family,” knowing your risks are higher in regards to certain diseases can become a huge distraction in one’s life. In the film, Joanna became completely absorbed in deciding what steps she should take in order to lower her risks. This same thing can happen to millions of people if they are prone to diseases like Alzheimer’s, heart disease, and especially cancer. If you know that you are at risk, you are going to do everything you can to curb your chances of the disease’s development. So although knowing may open up the doors for doctors to help you extend your life, the fact that so much focus and energy will have to be placed on what kind of options you have available can be life changing.
ReplyDeleteI think although the genome has been sequenced, the answers that it holds are still well beyond our span of knowledge. The thousand dollars it costs does not include analysis. I think this price can be deceiving as well as the information that the actual processing of the sequence has to offer us.
In terms of public health, the fact that this process is becoming cheaper and cheaper, means that we can develop better programs and figure out specific options that people find themselves available to them. Whether that means people are more prone to cancer or diabetes, this will surely help public health officials determine what future steps need to be taken in order to best help the public.
In regards to medical professionals, knowledge of what dosage and what each individual’s options are if they are at risk to specific diseases, as I said, would be dramatically life changing. Not only could doctors help to extend the lives of patients but they can make a difference in their patient’s lives as well. However problems can arise if people end up having a rare disease, or a newly developing one that doctors do not know a lot about. What if the outcomes are completely unexpected? This can complicate the matter of already finding out how prone you are to developing something. I think if you are going to be paying over $1000 for a process like this to be done, questions must be answered in order to have a satisfied customer. Because in the end, patients end up becoming customers, doctors are just providing their knowledge of options that will best appeal to the patients. Not to mention they could interpret the results wrong.
Government policies are going to become trickier. The question of who will be covered by insurance will always arise, as there are already loopholes in policies like GINA. The government is going to have to form new laws that apply to the entirety of those who have their genome sequenced; whether that be, they are more prone to something, or they have nothing to worry about. As the article said, no one but the scientists are ready for the world to be able to have the ability of sequencing an individual’s genome available to the public.
http://www.nature.com/ng/qoty/index.html
This article provided people’s individual responses to the question: What would you do if it became possible to sequence the equivalent of a full human genome for only $1,000?
Lowing the cost of genome sequencing is an amazing breakthrough. So many things that are "available" to the public such as sequencing a person's genome is much too expensive for the person to do, therefore it is not truly available. If there is something like this, I believe the way to make it truly USEFUL is to make it as affordable and available as possible. If people are able to get their genome sequenced, they will be able to make more informed decisions about their health, especially knowing what they are and are not more susceptible to.
ReplyDeleteBut like we learned in class, certain tests should not be given unless we understand the disease, have an accurate test available, know how to treat the disease, etc. While this is applicable with newborn screening, I think we should take a lot of these guidelines to heart when actually implementing tests after the genome is sequenced. I don't think it would be the best of ideas to scare patients into thinking they will automatically get a disease and become ill if we do not know the full information on what we're testing for specifically.
Overall, I definitely think it's a great leap in the right direction.
I think that the $1000 genome sequence is a great opportunity for a few people, but is still something that many other people cannot afford. Genome sequencing is not covered by health insurance, so people who want to have this test done must pay out-of-pocket for it. I think that in the future, if genome sequencing becomes more useful in determining risks for certain diseases, it will widen the health care gap between the wealthy and the poor.
ReplyDeleteGenome sequencing is also only useful if there is a way to combat/cure the disease that someone has or is pre-disposed to. If a person's genome sequence comes back, and they discover that they are pre-disposed to Alzheimer's, there is really nothing that he/she can do to prevent it from happening. I think that the value of genomic sequencing relies in the potential for a person to do something about their pre-disposition to certain diseases. If there is no cure/no prevention methods for the disease that a person is pre-disposed to, what is the value in getting your genome sequenced. I feel like people should really consult their doctor before going to get a test like this because I think that doctors can/or can be trained to offer advice to people on whether a genomic sequencing test would even be worth the money to get/interpret it.
I think that genome sequencing is a great service that can help the lives of many. Knowing what it is in your genome can help prevent disease or avoid them in being as deadly since preventative measures can be taken place. I think that it is unfortunate that health care does not cover this service. It is unfair that the wealthy get to partake in genome sequencing while the underprivileged do not. As if there weren't a big income inequality gap in this country already.
ReplyDeleteI believe that as genome sequencing becomes even cheaper and more widely available, it can take a toll on our already weak health care system. As more people get their genomes sequenced, this could increase the rates of disease surveillance on some people as well as more visits to health care professionals as people seek preventative measures for disease they are genetically predisposed to get. Therefore, they would be a higher demand for medical professionals. In addition, I could see the demand for genetic counselors sky rocketing. And I am greatly unsure if our health care system can handle having to provide additional services to more and more people.
In terms of governmental policies, I believe that strict laws must be put into place to protect the sensitive information that involved with genetic sequencing. I would like to see the government require that health care insurers cover the costs of genetic sequencing as well as making genetic sequencing affordable to those who do not. However, making insurance providers cover this could drive insurance prices up. And medical insurance is high enough already.
In terms of public health, I believe that the medical community as a whole would have to be educated about genetic sequencing and about its benefits and risks. I feel that genomics as a whole is a topic that is not widely discussed. I would want to insure that all medical providers are adequately educated about genetic sequencing and suggest to it patients who could greatly benefit from it based on their medical information.
I think that one of the biggest impacts we will see as a result of the $1000 Genome is the amount of misinformation that will start to be prevalent. As it is with many other things, people are prone to misinformation and rumors. The $1000 Genome is no different, for people who would prefer to try and interpret the results themselves instead of seeking a professional, they could either greatly underestimate or overestimate the degree of risk their genome portrays. The medical community will also have to take part in a great deal of education because people expectancy of doctor's proficiency in this field will increase due to the newfound acessability. The "settling" period that the country will experience from this will be influential in determining how effective and accepted this method will be. If people correctly inform themselves and seek the help of medical professional then I believe this will be an excellent tool for public health.
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ReplyDeleteI think that one of the biggest impacts we will see as a result of the $1000 Genome is the amount of misinformation that will start to be prevalent. As it is with many other things, people are prone to misinformation and rumors. The $1000 Genome is no different, for people who would prefer to try and interpret the results themselves instead of seeking a professional, they could either greatly underestimate or overestimate the degree of risk their genome portrays. The medical community will also have to take part in a great deal of education because people expectancy of doctor's proficiency in this field will increase due to the newfound acessability. The "settling" period that the country will experience from this will be influential in determining how effective and accepted this method will be. If people correctly inform themselves and seek the help of medical professional then I believe this will be an excellent tool for public health.
ReplyDeleteTo quote from the article ”Bottom line is, scientists are ready for the $1000 genome, but the governments, the medical system, doctors, and the general public are almost certainly not”. The real bottom line is scientists are ready to make some money! The title of Professor Chan’s blog post is supply and demand, and with my very base knowledge from Econ 101 it seems like the genome sequencers have done some research as to the most money they can charge and still receive maximum profit, and settled on a number of 1,000$. The article mentions that this one thousand dollars covers the sequencing not the analysis, so I’m a bit confused as to how much in the end this process and knowledge actually costs. On top of that storing your DNA is probably going to cost another amount of money, and if insurance companies want to hop on the train, they could probably insure the storage process. So in reality is it going to cost 1,000$, I’m not sure!
ReplyDeleteWith money aside I’m worried about the health impacts on society. Although it’s great we know how to read the genome and sequence it, the reality is we do not know with 100% accuracy everything about everyone’s genome. Not only do we not know why everyone’s genome is the way it is, we don’t know what will happen when we start messing with it. I think personalized medicine is a cool idea, but at the same time who is going to be personalizing this medicine, how much more education are these Doctors going to need, and the reality is I think the medical field is a long way from personalizing medicine effectively. According to the article Steve Jobs spent 100,000 dollars when he had cancer to sequence his genome. He spent all that money and what happened? He still died! The best part is that sequencing his genome would never save Steve Jobs life, it is the analyzing his genome that would. It’s time research continues to analyze genomes, charge less to sequence, charge more to analyze. We spent years and time on the Human Genome project, it’s time to spend the money on figuring out what it means before these sequencing companies try and make money!
I don’t have the answers but I will say until we understand more fully what my genome sequence means I am not getting sequenced anytime soon!
With the $1000 genome becoming widely available a number of changes will be taking place. First, individuals will have more access to their genetic code and be able to determine if they possess gene variants associated with Alzheimer’s, diabetes, heart disease or cancer. In order to understand such variants there will be a greater demand for genetic counselors to help individuals understand what their genomic sequence means for their health and in general. Additionally, there would be an increased demand for physicians not only to diagnose but also to treat. As discussed in the article, the $1000 genome would further allow physicians to better determine which drugs a patient should consider taking and at what dosage. In terms of the government, it seems that there would need to be regulations and review boards put in place to make sure that there were not companies trying to monopolize on genome sequencing, regulation of costs, in addition to guidelines for what is acceptable and valid to tell patients so that there is minimal, if any confusion about what certain genome variations mean in terms of health and available treatment. I think it is important to decrease the opportunities that could potentially be available to doctors to abuse the genome sequencing and prescribe unnecessary treatments, tests, and drugs. That being said, I think that there will be numerous implications on public health, medical professionals, and governmental policies that I cannot even begin to consider as I don't have enough knowledge on the topic to further speculate.
ReplyDeleteI think the decreasing price in getting the genomic sequence will be extremely beneficial for society. It will decrease the gap between the rich and the poor in accessing their genomic sequence. It will also help medical professionals in that they can be more efficient in helping their patients. They will know what to expect and will get an idea of how to go about providing treatments and informing their patients. It will also let them know to check the patients’ relatives for certain diseases as well. Government policies, however, will have to be stricter in dealing with nondiscrimination situations. Since more people can now have access, there can be room for more exceptions and different situations in deciding whether protection from government policies is necessary or not. This can be in regards to whether one should get protection if their disease won’t be present until much later in their lives.
ReplyDeleteThe article asks about whether it is better to know but be unable to treat the disease or to not know and never worry. I would argue that it is better to know, even if you are unable to treat it. That way, you will have time to mentally prepare yourself for the worst. If the disease is treatable, you will be able to make lifestyle changes knowing that it can help. Otherwise one might just regret not knowing, especially once the disease occurs, since they did have the opportunity to access this information.
However, it is important to consider the fact that the technology will show about 99% of the sequence. There is a chance that the remaining percent is the part of the sequence that contains information on the possible disease, and the sequencing wasn’t able to capture it. In that situation, it would seem pointless to spend so much money and not getting the information you were looking for. I think before people start paying for the sequencing, they should wait until the validity of the testing improves even more, which I don’t think will be too distant into the future.
I think this article is interesting because of the information learned in class regarding cheap genome sequencing, and its perspective from a media point of view. Hardly any doctors are mentioned in the article, so it lacks some credibility. The article points out famous celebrities getting their genomes sequenced but fails to mention the importance and the findings of these sequences. Yes, it’s interesting that a non-celebrity can get information about their genes, but what will people do with that personal, scientific knowledge?
ReplyDeleteSince more people could afford the research, the mystery behind individual’s genes would be demystified, but it could lead to chaos if not properly controlled. The $1,000 genome could cause more stringent government policies toward protecting rights against access to one’s genome. This is due to the possibility of employers or insurance companies wanting access to your results. In public health, if a person does not understand how to read a sequence properly, there could be mass confusion. As learned in class, 23andme.com only uses current findings about genes to assess risk for a disease. As Professor Chan stated, one person had their genome tested multiple times in a year and their risk varied every time. Medical professionals would have their offices overbooked with people misunderstanding test results and neurotic about getting a disease. I think it would be best for the government to get a handle on the $1,000 genome and make people aware that these results do not necessarily mean you are one hundred percent going to get an illness. Otherwise, people that get their genome sequenced may end up with a lot more headache then they bargained for.
It is incredibly fascinating to see that the price of sequencing the genome is continuously dropping. $1000 still seems like a lot in my eyes though and I don’t think I’d want to get my genome sequenced. I’d rather not know what diseases I’m likely to have. Plus, I think that even if I knew I was more likely to have a certain cancer, for example, there are not many cures out there for many of the serious diseases/conditions out there. In other words, I don’t think finding cures and sequencing the genome have caught up with each other yet. However, for other people, $1000 to sequence their genome and possibly alter their lives for the better because of it may be worth it to them. Knowing for themselves or for their children that they could develop a disease due to genetics would allow them to take preventative measures.
ReplyDeleteThis will have an effect on medical professionals and governmental policies as well. For one, job market for people to analyze the genome will increase as more people want to get their genome sequenced. In turn, new insurance policies and programs will have to develop to support such procedure. Finally, the government will have to implement some kind of privacy law to protect peoples’ records and prevent discrimination.
Overall, I think that the $1000 genome is a great achievement that will be beneficial to many people for years to come. Having our genome sequenced will allow us to identify mutations that pose a risk to health, assess our risk of actually developing the disease associated with our genetic variants, and plan ahead to prevent the disease from developing.
ReplyDeleteHowever, I agree with the article that although the scientific community is prepared for the $1000 genome, the general public, healthcare providers, and the government are not. Gaining unprecedented access to our entire genetic sequence has downsides to consider. First, just because we have the information we need doesn't mean it will be used correctly. Education is key for everyone involved, including the public and genetic counselors. Incorrect interpretation of genetic material can cause unnecessary worry, or on the other hand, relief over supposedly good news. Another thing to think about is whether parents should be able to have their young children sequenced. A child might spend years worrying about developing a disease that they never would have wanted to get themselves tested for.
Even with these downsides, I fully support the $1000 genome becoming a routine medical test. People will have to learn to adapt to the wealth of genetic information they have access to and use it correctly and effectively.
The fact that the science community is preparing for a $1000 genome is exciting, to say the least. I think this will be extremely beneficial for patients and the general public. Nobody is being forced to have their genome sequenced, but I am sure there are people who would like to know more about their genes. When Genome sequencing becomes available for $1000, it will be even more beneficial for a person who is afraid of having a certain dangerous gene that may put him/her at risk for a disease. Of course, with the sequencing also comes the question of: Will the patient be harmed more knowing that they have a high chance of being affected by a disease that cannot be cured such as Alzheimers, or would it be better to just never know? Well, this is why I mentioned that nobody is forced to go through this genome sequencing so this question seems a bit pointless. There are, in fact, people who are strong enough to receive bad news but still make the best out of their life, and this people would be good candidates for the $1000 sequencing (if they actually wanted to do it). There are others though, of course, that would not be able to live the rest of their lives knowing that they will possibly be affected by a disease in the future. Either way, this cheaper sequencing offers people who get their genome sequenced to take early action in case any risks or warning signs become apparent in their sequence.
ReplyDeleteAlthough it all sounds beneficial, I still believe it is too early to offer cheaper $1000 genome sequencing to the public as I do not believe that the general public has enough knowledge or education about genome sequencing to go through the process. I believe many people would blindly pursue the chance to get their genome sequenced but would not truly understand the ramifications followed by doing so. I believe doctors need to start slowly educating more of their patients about genome sequencing before simply offering the option for them. This will allow people who have interest in genome sequencing to fully understand what consequences there are (emotionally) in doing so.
While having a $1000 genome sequence makes access to the technology a lot more affordable to the general public, it does not cover the cost of interpreting the results, which is probably pricey. There is also a gap in general knowledge because the information is relatively new and the average person may not be capable of fully interpreting the results, so this can be dangerous if they misinterpret and do something like misdiagnose themselves and take the wrong course of actions.
ReplyDeleteI also feel as though people may start trying to be their own doctors, which may put more strain on the medical infrastructure which in itself is already stretched thin. More access to information creates this problem. People may start trying to say that they need more screens or more tests just because of some results they received from their sequence interpretation, which is creates unnecessary costs and wastes time and takes away from services that other more vulnerable people would need.
For the government, they are not ready to regulate such an industry yet. The research from this field is relatively new, and it will take government some time to catch up and figure out ways to regulate this industry to protect individuals.
So I will agree with the author of the article when he says that the "governments, the medical system, doctors, and the general public are almost certainly not" ready for this $1000 genome sequence. It will take some time for those sectors to assemble the resources and power to manage such a powerful technology.