Optimizing Precision Medicine for Public Health

Abstract

Advances in precision medicine have presented challenges to traditional public health decision-making paradigms. Historical methods of allocating healthcare funds based on safety, efficacy, and efficiency, are challenged in a healthcare delivery model that focuses on individualized variations in pathology that form the core of precision medicine. Public health policy and decision-making must adapt to this new frontier of healthcare delivery to ensure that the broad public health goals of reducing healthcare disparities and improving the health of populations are achieved, through effective and equitable allocation of healthcare funds. This paper discusses contemporary applications of precision medicine, and the potential impacts of these on public health policy and decision-making, with particular focus on patients living with rare diseases and rare cancers. The authors then reconcile these, presenting precision public health as the bridge between these seemingly competing fields.

Healthcare System Priorities for Successful Integration of Genomics: An Australian Focus

“…More robust and transparent data collection on genomic testing activity will allow governments and consumers to monitor and evaluate this part of the healthcare system, to ensure that the use of genomics is safe and equitable, as well as effective. Similar data could also increase our ability to assess the wider benefits of investing in genomic testing, through demonstrating the outcomes of knowledge translation from rare genetic diseases to more common, complex conditions ( 44 ). Evaluation is described as a cornerstone for the successful translation of genomics technology into healthcare practice, and is a key function of public health genomics ( 45 – 48 ).…”

Bioengineering horizon scan 2020

“…One is ensuring equitable access. Reimbursement from third-party payers such as health insurance companies is also likely to become an issue for targeted treatments (Bilkey et al, 2019;Genetics Home Reference, 2019). Public health policy must adapt to this new frontier of healthcare while addressing its potentially detrimental effects on equality of healthcare access and treatment.…”

Challenges in the clinical implementation of precision medicine companion diagnostics

“…This review assesses the clinical diagnostic testing landscape supporting PM and the challenges to clinical implementation of CDx tests based on real-world evidence derived from patient data collected during routine clinical health care delivery. The validity of tracking such observational data sets to find associations with health outcomes has been demonstrated and acknowledged in several studies [15][16][17]. The authors review published literature and insights in the 'Pharma Precision Medicine Readiness Report 2019,' a longitudinal analysis of the commercial and organizational readiness of biopharmaceutical companies and other stakeholders within PM regarding CDx testing (available at https://www.diaceu tics.com/pmreport19/) [13], published by Diaceutics, a data analytics and implementation service provider in diagnostic commercialization.…”