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东南亚个体化医学应用和实施的现状。

Current landscape of personalized medicine adoption and implementation in Southeast Asia.

机构信息

School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia.

United Nations University International Institute for Global Health, Kuala Lumpur, Malaysia.

出版信息

BMC Med Genomics. 2018 Oct 26;11(1):94. doi: 10.1186/s12920-018-0420-4.

Abstract

BACKGROUND

The emergence of personalized medicine (PM) has raised some tensions in healthcare systems. PM is expensive and health budgets are constrained - efficient healthcare delivery is therefore critical. Notwithstanding the cost, many countries have started to adopt this novel technology, including resource-limited Southeast Asia (SEA) countries. This study aimed to describe the status of PM adoption in SEA, highlight the challenges and to propose strategies for future development.

METHODS

The study included scoping review and key stakeholder interviews in four focus countries - Indonesia, Malaysia, Singapore, and Thailand. The current landscape of PM adoption was evaluated based on an assessment framework of six key themes - healthcare system, governance, access, awareness, implementation, and data. Six PM programs were evaluated for their financing and implementation mechanisms.

RESULTS

The findings revealed SEA has progressed in adopting PM especially Singapore and Thailand. A regional pharmacogenomics research network has been established. However, PM policies and programs vary significantly. As most PM programs are champion-driven and the available funding is limited, the current PM distribution has the potential to widen existing health disparities. Low PM awareness in the society and the absence of political support with financial investment are fundamental barriers. There is a clear need to broaden opportunities for critical discourse about PM especially for policymakers. Multi-stakeholder, multi-country strategies need to be prioritized in order to leverage resources and expertise.

CONCLUSIONS

Adopting PM remains in its infancy in SEA. To achieve an effective PM adoption, it is imperative to balance equity issues across diverse populations while improving efficiency in healthcare.

摘要

背景

个性化医学(PM)的出现给医疗体系带来了一些紧张局势。PM 成本高昂,而卫生预算有限,因此高效的医疗服务提供至关重要。尽管成本高昂,但许多国家已经开始采用这种新技术,包括资源有限的东南亚(SEA)国家。本研究旨在描述 SEA 国家采用 PM 的现状,强调面临的挑战,并为未来发展提出策略。

方法

本研究采用范围综述和在四个重点国家(印度尼西亚、马来西亚、新加坡和泰国)进行的关键利益攸关方访谈。根据六个关键主题的评估框架,评估 PM 采用的现状-医疗体系、治理、获取、意识、实施和数据。评估了六个 PM 项目的融资和实施机制。

结果

研究结果表明,SEA 国家在采用 PM 方面取得了一定进展,尤其是新加坡和泰国。已经建立了一个区域性的药物基因组学研究网络。然而,PM 政策和计划存在显著差异。由于大多数 PM 计划都由倡导者推动,而且可用资金有限,目前 PM 的分布有可能扩大现有的健康差距。社会对 PM 的认识度低,以及缺乏政治支持和资金投入,是根本性的障碍。显然需要为政策制定者提供更多关于 PM 的关键性讨论机会。需要优先考虑多利益攸关方、多国家战略,以利用资源和专业知识。

结论

PM 在 SEA 的采用仍处于起步阶段。为了实现有效的 PM 采用,必须在不同人群中平衡公平问题,同时提高医疗服务的效率。

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