It’s a tremendous, disruptive opportunity for the individual as well as the industry.

Question: What do you think of startups that give people access to their genetic information?

Fred Hassan: I think knowing one's personal information gives one tremendous power, because now one can say, look, I might have a higher risk of breast cancer or a higher risk of Alzheimer's, and what can I start doing now to do better regarding exercise, diet, even some interventions now, so that I can delay the onset of a possible problem by several years or even decades? That's an opportunity for the industry. The fact that people can learn more about themselves, and number two, take on a lifetime of disease management for themselves -- this is a very, very good development because it makes people more responsible for their own health care. And if our industry can develop the tools and can relate to this new development with new innovations, new drugs, that are very specific to individual people or to subpopulations of people, then it's a chance to reduce the waste that exists in our system in failed clinical trials, and also to reduce the waste in terms of medicines that might be taken by people that may not work or that might cause side effects. So it's a tremendous, disruptive opportunity for the individual as well as the industry.

I think the industry is very good at what it does, and there are always groups inside the industry that are very forward-looking and that are very anxious to be moving in this direction. You always have smaller companies coming up, and maybe with more flexibility and with more creativity, that are more in tune with the more recent trends. In terms of personalized medicines, the one big hope that we have is that communities of patients will start to group together once they know more about themselves, and as a result of grouping together they will then create the pressure from the bottom toward the regulatory authorities to also improve the flow of medicines.

A good example is that when the community of patients with HIV started to come together in the '80s and create this bottom-up pressure, that's when the regulatory pathway started to open up. And as a result we have now seen that in less than 25 years we've not only been able to describe a new disease that's emerged, but also describe the virus and then start to come up with drugs that have stabilized the disease. What used to be a death sentence has now become a chronically managed disease. I believe a lot of the disruptive change can occur from the patients up, as opposed to only coming from the manufacturers.

Question: How with big pharma companies fit into this genetic innovation?

Fred Hassan: I think we will see both acquisitions, but more importantly partnerships. Some companies might make acquisitions just to bring a change in their internal DNA. You literally buy a smaller company and use that opportunity to change the internal DNA. In many other cases, companies will seek to partner with smaller companies to acquire their expertise, to also improve their own internal DNA and to be a part of the opportunity here that's definitely going to open up. It's already happened in breast cancer to some extent, because now we know that about 25 percent of breast cancers are HER2 positive, and they need to be treated separately from the other 75 percent, and that there is a drug called Herceptin that works very well in these 25 percent of breast cancers. Similarly, as patients start to learn more about other kinds of diseases, such as Alzheimer's, and know that there might be specific approaches to their subset of Alzheimer's disease, you will see a tremendous demand coming from that area and big companies reaching out to smaller companies with expertise to help them meet that demand.

Recorded on November 6, 2009