The End of Medicine as we know it

Harald H.H.W. Schmidt
Department of Pharmacology and Personalised Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands

Following the IT revolution, the next socio-economic revolution appears to be a complete redefinition of health and disease, how we define them, how we handle them and how we finance this. Such revolutions follow upon a major crisis, and medicine is in a crisis. Existing drugs fail to provide benefit for most patients. The efficacy of drug discovery is in a constant decline and big pharma about to disappear in its current form by the end of the 2020s. Biomedical research has a poor translational success rate due to false incentives, lack of quality/reproducibility and publication bias. The most important reason and need for change, however, is our current concept of disease, i.e. mostly 19th/20th century-derived and based on organs or symptoms, but hardly every by mechanisms. Without a disease mechanism, however, no curative therapy is possible. Enabled by big-data and interdisciplinary research with applied bioinformaticians, the new Systems Medicine will lead to a mechanism-based redefinition of disease, precision diagnosis and therapy eliminating the need for drug discovery and a complete reorganization of how we teach, train and practice medicine.

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