One major turning point of the industrial revolution was Henry Ford and his Model T car factory.What was unique about the factory was that it churned out thousands of the same car (Model T), in the same color (black), at a relatively inexpensive price. As he famously claimed, he wanted to build a car that his workers could afford. The resulting assembly line provided decent, if somewhat monotonous, jobs (parodied by Charlie Chaplin in Modern Times). But the product was affordable, starting at $825 dollars, and dropping to around $300 near the end of production.

Pharmaceutical companies also adopted the assembly line model in their early years. Most medicines that made billions for them were similarly mass produced. It did not matter how fat or thin a person was, how tall or short, old or young, or of what ethnicity. They would take the same dose of the medicine on the same schedule. Except for chemotherapy drugs, this system worked just fine up to a point. Over the past decade, however, the cost of drugs has been increasing dramatically.Even with the assembly line model, overall healthcare now costs the US 18% of GDP, and individuals, as well as the society, are going bankrupt trying to afford the “best” healthcare that can be bought.

Now we have another wrinkle. Technology has individualized drugs and personalized medicine. Technology such as Dendreon’s Provenge can treat only one patient with a particular drug since it is highly personalized, having been derived from that person’s own immune system. Naturally, the cost savings of an assembly line cannot operate here, and the cost of treatment is about $93,000 a year for a few extra months of life. Other technologies such as CAR-T therapy for cancer and CRISPR-CAS9 for genetic editing are also very personalized. Though, companies that have this technology are worth their weight in gold-pressed platinum (Star Trek), how many patients will be able to really afford it?

The US cannot afford to spend more on healthcare than it already is. The tax bill making its way through Congress will force Medicare and Medicaid to slash spending in a few years by as much as 30%. How will we afford personalized medicines? 

While technology marches on, the economics of personalized medicines just don’t add up. Will they be like costly trinkets being displayed in a museum that we can watch at a distance but not own? 

Investors have had lots of gains with CAR-T cell or CRISPR-CAS9 companies such as Juno (JUNO), Kite Pharma (KITE) and Editas (EDIT ).Will patients similarly gain?