Magic bullet or marginal bet—does precision medicine offer the best hope for sick individuals and sick populations?

Abstract By targeting treatment according to molecular biomarkers, precision medicine promises a revolution in healthcare. We examine this promise by distinguishing three precision medicine strategies: biomarker-stratified-high-risk-targeting, biomarker-based-individual-targeting, and biomarker-based-disease-targeting. Each strategy seeks to boost one of the determinants of the population impact of a medical intervention. We conclude that these strategies give a molecular coating to decades-old tactics. There is no compelling reason to believe that precision medicine strategies are uniquely effective for sick individuals or sick populations.