A new trial claims to cure severe diabetes with a stem cell infusion. How much potential do such trials have? Dr Gaurav Kharya, senior consultant, paediatric hematology and bone marrow transplant, Indraprastha Apollo Hospitals, says: “Stem cell therapies hold immense potential for curing chronic diseases like severe diabetes, particularly Type 1 diabetes, where the body’s immune system destroys insulin-producing beta cells. A recent trial showing reversal or control through stem cell infusion is promising, as it aims to regenerate or replace damaged pancreatic cells. While early results are encouraging, such trials are still in preliminary stages and often limited by small sample sizes and short follow-up durations. Long-term safety, scalability, immune rejection, and consistent efficacy are critical hurdles before these can be considered viable treatments. However, the potential is undeniable — if future trials succeed, stem cell therapy could reduce or even eliminate insulin dependency. That said, regulatory approvals, costs, and ethical concerns still need to be addressed. Overall, stem cell infusions for diabetes represent an exciting frontier, but we’re a few years away from routine clinical application.”
What are the challenges in mass adoption of personalised medicine?
Personalised medicine, especially in oncology and rare diseases, offers treatment tailored to an individual’s genetic profile, potentially increasing efficacy and reducing side effects. Despite its promise, its mass-scale adoption remains limited due to several barriers. First, the cost of genetic testing, targeted therapies, and advanced diagnostics is high, often making them inaccessible to large populations, especially in low- and middle-income countries. Second, healthcare infrastructure and training to interpret and apply such data are still lacking. Third, data privacy, regulatory concerns, and fragmented clinical trials slow progress. Moreover, pharma companies still operate on a one-size-fits-all model for commercial viability, which contradicts the bespoke nature of personalised care. Insurance coverage is also limited, making out-of-pocket expenses prohibitive for most. Until these challenges, particularly cost, awareness, and integration with primary care, are addressed, personalised medicine will remain largely niche rather than mainstream.
What is the availability of personalised medicine in India?
In India, personalised medicine is steadily gaining ground, especially in oncology, rare genetic disorders, and cardiology. Genetic testing is the most widely used approach-tools like BRCA gene testing for breast cancer, pharmacogenomic profiling to assess drug response, and NIPT (non-invasive prenatal testing) are becoming more common in urban healthcare settings. Stem cell therapies are available in specialised centres for certain conditions such as blood cancers (bone marrow transplants), spinal cord injuries, and some autoimmune diseases.
However, these interventions are typically expensive and available only in premium hospitals or research centres. Start-ups and genomic companies like MedGenome and Mapmygenome are helping increase accessibility to genetic testing for preventive health. Still, a large gap exists between urban and rural availability, and awareness remains a major barrier. While India has a growing base for personalised medicine, widespread implementation is still in early stages and largely limited to high-income segments.
Can personalised medicine become pharma-based for wider reach?
For personalised medicine to be more widely available, integration into mainstream pharmaceutical systems is essential, but it is complex. Traditional pharma operates on scalable, uniform treatments that serve broad populations, whereas personalised medicine tailors therapies to an individual’s genetic or molecular profile. For pharma to adopt this model, drug development needs to shift toward biomarker-based segmentation, requiring smaller, targeted clinical trials and potentially less blockbuster revenue. However, advances in AI, genomics, and bioinformatics are beginning to bridge this divide, enabling pharma companies to co-develop diagnostics and companion drugs. Regulatory bodies are also evolving frameworks to fast-track personalised therapies. If these drugs can be manufactured at scale using modular production and supported by insurance and government policies, broader access is possible.
Public-private partnerships, investment in genetic databases, and pricing models for low-income countries will also be key. In time, a hybrid model-where pharma delivers personalised drugs based on standardised genomic protocols-may become viable.
