• Albrecht Stenzinger, Ejner K Moltzen, Eva Winkler, Fruzsina Molnar-Gabor, Nisar Malek, Alexandru Costescu, Brigitte Nybo Jensen, Frédérique Nowak, Carmine Pinto, Ole Petter Ottersen, Peter Schirmacher, Jenni Nordborg, Thomas Seufferlein, Stefan Fröhling, Anders Edsjö, Jesus Garcia-Foncillas, Nicola Normanno, Bettina Lundgren, Mikaela Friedman, Natacha Bolanos, Katrina Tatton-Brown, Sue Hill, and Richard Rosenquist.
• Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
• J. Intern. Med. 2023 Oct 1; 294 (4): 437454437-454.

AbstractThe technical development of high-throughput sequencing technologies and the parallel development of targeted therapies in the last decade have enabled a transition from traditional medicine to personalized treatment and care. In this way, by using comprehensive genomic testing, more effective treatments with fewer side effects are provided to each patient-that is, precision or personalized medicine (PM). In several European countries-such as in England, France, Denmark, and Spain-the governments have adopted national strategies and taken "top-down" decisions to invest in national infrastructure for PM. In other countries-such as Sweden, Germany, and Italy with regionally organized healthcare systems-the profession has instead taken "bottom-up" initiatives to build competence networks and infrastructure to enable equal access to PM. In this review, we summarize key learnings at the European level on the implementation process to establish sustainable governance and organization for PM at the regional, national, and EU/international levels. We also discuss critical ethical and legal aspects of implementing PM, and the importance of access to real-world data and performing clinical trials for evidence generation, as well as the need for improved reimbursement models, increased cross-disciplinary education and patient involvement. In summary, PM represents a paradigm shift, and modernization of healthcare and all relevant stakeholders-that is, healthcare, academia, policymakers, industry, and patients-must be involved in this system transformation to create a sustainable, non-siloed ecosystem for precision healthcare that benefits our patients and society at large.© 2023 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.

13 keywords...

hide…