Ian Jacob

Stratified medicine: a call for action.

The practice of medicine is changing and the future of this practice is becoming more evident. The end of the pharmaceutical blockbuster, where a treatment has widespread coverage, has made way for more targeted treatments aimed at smaller stratif ied population groups. Stratified medicine can be used to target preventative, screening or treatment strategies. It is theorized that eventually these targeted treatments will result in unique, individually tailored treatments, heralding an era of true personalized medicine. The current literature is scattered with definitions of stratified medicine and personalized medicine where these terms are used interchangeably but most practical or clinical applications of personalized medicine are actually stratified medicine. With the advent of new genetic technology, there will come a time when personalized medicine is possible in which a treatment option is targeted to the genetic characteristics of an individual tumor or patient. The focus in this editorial is the use of stratified medicines using the definition as a therapeutic combined with a companion diagnostic that targets a patient subpopulation for treatment [1]. The purpose of this editorial is to provide an overview of stratified medicine, describing the anticipated benefits and major challenges, ultimately making recommendations to ensure a smooth transition toward this new paradigm. We draw on the experiences of an EU Framework Seven Program (FP7) funded project that aimed to develop and assess a toolkit of criteria and procedures when conducting health technology assessments of genetic technologies [101].