Synthesizing Science, Policy, and Precision Medicine: A Conversation with Kathryn A. Phillips, PhD

Department of Clinical Pharmacy Professor Kathryn A. Phillips, PhD, who is also the founder and director of the UCSF Center for Translational and Policy Research on Precision Medicine (TRANSPERS), has been bridging the worlds of health economics, precision medicine, and policy for decades. 

Now, as she’s wrapping up a Bioethics Scholar residency in Geneva, Switzerland, her global leadership is being honored with the 2025 UCSF Academic Senate’s Faculty Research Lecture in Social, Behavioral, and Health Policy Sciences. The honor comes as TRANSPERS nears its 20th anniversary of producing timely policy research — most recently publishing a Journal of the American Medical Association paper on payer coverage for Alzheimer’s disease blood tests. 

We spoke with Phillips about her cross-disciplinary journey, the evolution of precision medicine, and what’s next for health policy and equity. 

Q: What does receiving this UCSF Faculty Research Lecture award mean to you at this point in your career? 

A: What’s especially meaningful to me is that it recognizes my cross-disciplinary work. Research is often rewarded for being very narrow, but I’m a big thinker who has worked across many fields. I’ve worked in HIV and cancer, and then I moved into precision medicine. Now I’m doing some work in open science, so I don’t limit myself. I synthesize across multiple perspectives and stakeholders, including academics, payers, labs, and regulators. To have my work — and my way of working — recognized in this way is really gratifying. 

Q: One of your areas of focus is the payer landscape for Alzheimer’s blood tests. Why is this work so urgent now?

A: Our population is getting older, and people are at high risk for getting Alzheimer's or other dementias, particularly as they live longer. I saw firsthand how devastating Alzheimer's is because my mother died of the disease. We have some drugs that may slow its progression, but they’re expensive and can be dangerous for some patients. 

Now we need reliable diagnostics to help diagnose and to determine who will benefit from these new drugs. And we need precision medicine to target these drugs appropriately.  

Blood-based biomarker tests could revolutionize access — especially compared to invasive or expensive options like PET scans — but they’re not yet covered by insurance. My team and I just published a paper in Journal of the American Medical Association that recommended a set of coverage and policy considerations before these tests are out in the market. The hope is to develop good tests that are affordable and accessible and that can be implemented in the health care system. We need to anticipate payer questions to avoid widening health disparities. 

Q: You’re currently at the Brocher Foundation in Switzerland as a Bioethics Scholar. What drew you there? 

A: I’ve never formally studied bioethics, but I realized that the ethical dimensions of precision medicine are deeply connected to the policy and economic questions I’ve always explored. At Brocher, I’ve been learning from bioethicists and thinking about how we can combine economic analysis with ethical frameworks, especially when we’re talking about access, affordability, and fairness. These are critical issues in pharmacy and drug development. 

Q: You recently contributed to a new National Academies of Sciences, Engineering, and Medicine report on aligning therapeutic development with unmet need. What was the goal of that effort? 

A: This was a very intensive, year-long project to examine why our massive investments in drug development don’t always align with disease burden. It was one of the hardest things I've done, but it was also one of the most interesting things that I've done, and very related to what the UCSF School of Pharmacy does in terms of basic discovery, clinical implementation, and policy issues. 

We took a very holistic view of how to define “unmet need,” and looked at what types of strategies can address those unmet needs, whether it's scientific discovery, regulatory approaches, or payment approaches. You really need all of those to fix the system as a whole. 

One very promising development that was reinforced by our recommendations is the ability of Medicare to negotiate drug prices. It’s limited in scope, but it’s evolving, and it signals a shift toward fair pricing and providing coverage for drugs based on their value.

Q: How challenging is it to make an impact on a complex system like health care policy? 

A: It can be very challenging. One of the key strategies I’ve taken is to remain objective. TRANSPERS don’t advocate for specific policies, leaving that up to other stakeholders in the system. Instead, we focus on being a trusted, evidence-based intermediary, providing the information that others can take in to develop policies. That neutrality has been critical to our credibility with payers, regulators, and other decision-makers.  

That said, when I first started linking science and policy, like in a JAMA paper I co-authored in the early 2000s on pharmacogenomics, there was definitely skepticism. A basic science collaborator told me I was “crazy” and didn’t understand the methods or terminology I was using. But he stuck with the project, and we still talk about that paper today. It helped demonstrate that science, economics, and policy need to be integrated.  

Q: TRANSPERS is nearing its 20th anniversary. What’s the center’s legacy so far? 

A: I thought we needed a center on translating precision medicine into clinical care and health policy, and I was fortunate to have an NIH Program Project grant that helped me launch my idea. It has been really rewarding to see it become the premier center of its type in the world, and now we’re reflecting on where we’ve influenced coverage decisions, what we’ve published, and where we go next. We're thinking about all the new precision medicine tests that are continuing to come out, and the fact that we're at the tip of the iceberg in terms of the potential application of precision medicine.