Connetics Consulting, Minneapolis, Minnesota, USA.
Institute for Policy Advancement Ltd., Washington, DC, USA.
Am J Med Genet C Semin Med Genet. 2023 Mar;193(1):56-63. doi: 10.1002/ajmg.c.32032. Epub 2023 Jan 23.
Genomic and gene-targeted therapies hold great promise in addressing the global issue of rare diseases. To achieve this promise, however, it is critical the twin goals of equity in access to testing and diagnosis, and equity in access to therapy be considered early in the life cycle of development and implementation. Rare disease researchers and clinicians must simultaneously recognize the life-altering potential of early diagnosis and administration of gene-targeted therapeutics while acknowledging that not everyone who experiences a rare disease and needs these therapies will be able to afford or access them. Achieving equity in the development of and access to gene-targeted therapies will not only require innovations in research, clinical, regulatory, and reimbursement frameworks, but will also necessitate increased attention to the ethical, legal, and social implications when establishing research paradigms and the translation of research results into novel interventions for rare genetic diseases. This article highlights and discusses the growing importance and recognition of health equity across the spectrum of rare disease research and care delivery.
基因组和基因靶向治疗在解决全球罕见病问题方面具有巨大的潜力。然而,为了实现这一承诺,在开发和实施的生命周期早期,就必须考虑到获得检测和诊断的公平性以及获得治疗的公平性这两个双重目标。罕见病研究人员和临床医生必须同时认识到早期诊断和基因靶向治疗的改变人生的潜力,同时承认并非每个患有罕见病并需要这些疗法的人都能够负担得起或获得这些疗法。在基因靶向治疗的开发和获得方面实现公平性不仅需要在研究、临床、监管和报销框架方面进行创新,还需要在建立研究范式和将研究成果转化为罕见遗传疾病的新干预措施时,更加关注伦理、法律和社会影响。本文强调并讨论了在罕见病研究和护理提供的整个范围内,健康公平性的重要性和认识不断提高。