Monday, September 26, 2005

Last week I heard a great talk by the president of Arizona State University about research progress being made at the University and by its partner, the Translational Genomics Institute, in personalized medicine.

Yesterday I saw an article in the Wall Street Journal about what would happen as Boomers turn 60, asking for those personalized solutions to the health problems of aging.

But only this morning did I get my first taste of personalized medicine (albeit on a limited scale) and what the real implications and ramifications are for the future. My taste is only an hors d'oeuvre, believe me, compared to what's coming.

My foray into personalized medicine came on www.drweil.com, the new site Dr. Andrew Weil has created to sell his line of supplements. I've followed Andrew Weil's work for many years, always with great respect. I know he's not a charlatan, and I know he is a pioneer. I also know that, as a university-based physician, he hasn't entered the field of vitamin supplements to build a multi-leval marketing empire. So when I saw him on the Today show, I decided to see whether he had anything to offer me as I wage my personal war against the ravages of aging.

Dr. Weil has a feature on his site called the Vitamin Advisor. If you are willing to fill out a fairly detailed questionnaire about your health concerns and the advice your primary care physician has given you, and if you know a little bit about your own health, you can come out with a program adapted to your individual needs. The software takes your answers and figures out that someone my age who drinks alcohol but doesn't smoke, exercises and sleeps well but has arthritis, should take certain supplements -- everything from calcium to milk thistle.

After I filled everything out, I was asked to rank my concerns. Is it more important for me to increase my energy than to preserve my memory, for example. I care a great deal about optimal health, so I ranked all the concerns either high or moderate.

The software then kicked out a supplement program for me. 33 pills a day. The cost per pill, in each case, was pretty low--maybe $.64 for calcium. The supplements come in individual packets, so you can carry them with you, and so you won't forget what to take when. The order is shipped to your home.

But then came the check out piece. The software asked me: Do you want a 30 days supply? Or 90 days so you can save on shipping? I calculated the cost of my supplements both ways, and found out that for 90 days, the cost of the program for me would be a whopping $663.00. Not to mention the cost of my time as I try to swallow those 33 pills. Or the opportunity costs of what I COULD have done with that $663.00.

I finally decided to go one month at a time. I also eliminated a few concerns. If I run out of energy, I'll take a nap. I got it down to 26 daily pills and $183.00 per month, but I couldn't go any further without compromising what I consider my quest for optimal health.

So I got out the trusty credit card that gives me frequent flier miles, and I hit send.

What have I bought? An elegant personal solution to my supplement "problem", combining technology and medicine. Supplements made by a man I trust, in dosages I believe are correct for me. Something I think might help me live better, if not longer. A different program than what I had been on, which consisted of large bottles purchased at Costco. What had I been thinking, trying to save money on my health? Who knows what's in those Kirkland vitamins? I got my first wakeup call when I looked at the Vitamin E I've been taking and found out it was made from d-alpha tocopherol, which Dr. Weil says doesn't do anything for you. (You have to have mixed tocopherols in your Vitamin E.)

Fortunately, I have the wherewithall to pay close to $200 a month for vitamins. Now think of the Baby Boomers coming right behind me. Think about how close we are coming to a two-tiered health care system: concierge medicine and Andrew Weil supplements for those of us with the money to spend and the willingness to spend it on ourselves; Wal-Mart supplements for the others. Or even more complex, a health care system in which all things are possible, but few of them are affordable.Is it our genetics that will determine how long we will live, or our finances?

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