In terms of growth, competitiveness and employment, biotechnology is one of the most promising developing spaces impacting business.

Clinical genetics 

Genetic medicine looks at individual genes to understand how they can increase the risk of certain diseases or conditions. Medical genetics as a specialist clinical area emerged in the 1950s and has grown rapidly since then. It is now one of the fastest growing areas of medicine. Specialist services exist in most countries aimed at helping and supporting patients who have genetic conditions, who may be at risk of developing a genetic condition or who are concerned about their family history. Clinical teams typically consist of clinical genetics doctors, genetic counsellors, family history coordinators and administrative staff, who work closely with scientists in the laboratory.

In Ireland, the National Genetics and Genomics Office (NGGO) was established in 2023 to drive the implementation of the National Strategy for Accelerating Genetic and Genomic Medicine in Ireland and improve Ireland’s genetic and genomic medicine services. 

Implications of genetics for healthcare 

The predictive power of genetic information is unprecedented and is likely to result in healthcare systems to move from ‘Diagnose and Treat’ to ‘Predict and Prevent’. In this scenario a new category of ‘patient’ will exist – people who are currently healthy but are confirmed as having a genetic predisposition to a certain disease – and which may necessitate the creation of an entirely new class of individuals for healthcare. It is likely that even a small shift in the number of people seeking pre-symptomatic advice will shift the dynamics in a healthcare system of a country. 

What this means for employers, insurance companies and third parties

1. Employers: The literature is full of suggested links between the working environment and the illnesses that workers can experience. Particular environments can give rise to chronic conditions. Some occupations make heavy physical demands whilst others are extremely sedentary. Others are associated with hazards such as lead, mercury, carbon monoxide and asbestos, and stress-related illnesses can also be linked to the workplace. As with insurance, the acquisition of genetic information by employers about particular individuals is likely to be of enormous value to employers.
    
2. Insurance companies: Historically, characteristics such as age, sex, race, weight and medical history have been used to determine or deny insurance coverage. It is possible that individuals shown by genetic testing to be at increased risk of developing a common disease or a late onset disorder like Alzheimer’s Disease, may be asked to pay higher premia.
   
   A number of European countries (e.g. Austria, Belgium, Denmark, France, the Netherlands, Norway) have imposed legislation to prevent insurers from obtaining, or making use of, genetic test results in respect of insurance applicants. In other countries, such as Finland, Germany and Sweden, there are industry codes of practice under which insurers do not have access to genetic test results. Practice will largely be dictated by the type of healthcare system that exists in a particular country. Genetic tests will be advantageous to individuals within public healthcare systems like the NHS as there cannot be any exclusion from treatment. In the future, it will be important for insurers to be able to balance the exclusion of some prospective policy holders with the inclusion of at-risk individuals. Insurers will have little interest in excluding too many people as it defeats the purpose of insurance.
    
3. Third parties: Genetic information is generally accepted to be different from other forms of medical information. First, it is possible to see a person’s genotype (genetic make-up) independently of their phenotype (visible physical characteristics) and information about that person’s health status may be revealed without any manifestation of disease. Secondly, genetic information remains the same throughout life, and finally, genetic information is not simply the ‘property’ of an individual. As genes are shared with others, arguably the information belongs to the biological family as a kind of ‘corporate genetic personality’. 
    

‘GenEthics’ 

Almost all academic disciplines are recognising the need for discussion about the social and ethical issues surrounding genetics and a substantial literature is emerging about the possible consequences for society that the advances in genetics are likely to entail. Complex bioethical challenges require public debate in a way that is as open and transparent as possible, to make sure that all possible voices are included¹,  particularly young people.² 

Genetics is a global issue

It might be unrealistic to say that we are on the cusp of both biological and ideological revolution which will involve changes in our current thinking about health and disease, patterns of behaviour, laws and institutions, and our perceptions about humankind.

Advances in genetics should be supported providing research demonstrates them to be safe and effective, and providing the appropriate regulatory and social supports, such as genetic counselling and the protection of genetic information, are in place. Regulation should always work in the public interest, and needs to be strong enough to warrant public confidence, yet flexible enough to still encourage advances being made. Greater genetic health promotion and improved public participation in future debates about genetics is also required on a global level.
 

Could biotechnology impact your business?

The complexity of reality requires detailed consideration of its social, political, economic, legal and philosophical dimensions and concepts like liberty, equality and justice take on a new importance for the assumptions that underpin policy making. The best time to address a problem is always before a crisis. Although many of the early promises made about the enormous potential of genetics have yet to be fully realised, now is the time to explore areas of contention and to use the opportunity to discuss our shared future. 

At RSM, transforming knowledge into a competitive advantage for our clients is key. Should you wish to discuss how biotechnology could impact your business in relation to growth, competitiveness or employer matters, please get in touch. 

[1] Iredale, R. (2016). The use of Citizens' Juries in addressing complex bioethical challenges. ELS. 10.1002/9780470015902.a0026589 

[1] Anderson C, Stackhouse R, Shaw A, Iredale R. The National DNA Database on trial: engaging young people in South Wales with genetics. Public Understanding of Science. 2011;20(2):146-162. doi:10.1177/0963662510375793