Tuesday, February 7, 2017

Brief Blog: PMC Publishes Two Open Access Papers on Access to Personalized Medicine

The Personalized Medicine Coalition has published an open-access white paper and an open access journal article on the integration of precision medicine in healthcare.

The five-page white paper is online at PMC, here.  See the contributors list for a who's-who of thought leaders.

The 12-page academic article, by Pritchard et al, is online at the journal Personalized Medicine (14:141-152), here.

  • In addition Pritchard et al:
    • See similarly, a six-page new article in Journal of Precision Medicine by Subha Madhavan, "Barriers to Implementation of Precision Medicine in the US Health System," here.
    • See similarly, a ten-page review in Genome Medicine on barriers to precision cancer medicine, by Bertier et al, here.

    • In October 2016, JAMA op ed by Dzau et al. on barriers to the full potential of personalized medicine in healthcare, here.
    • On a different note, in April 2017, in NEJM Parikh et al. argued that "precision healthcare" should go far beyond "genes" and integrate diverse customization efforts, here

Abstract of Pritchard et al., after the break.
Pritchard et al.  (2017)

Strategies for integrating personalized medicine into healthcare practice.

Abstract:

Aim: Research and innovation in personalized medicine are surging, however, its adoption into clinical practice is comparatively slow. We identify common challenges to the clinical adoption of personalized medicine and provide strategies for addressing these challenges.
Methods: Our team developed a list of common challenges through a series of group discussions, surveys and interviews, and convened a national summit to discuss solutions for overcoming these challenges. We used a framework approach for thematic analysis.
Results: We categorized challenges into five areas of need: education and awareness; patient empowerment; value recognition; infrastructure and information management; and ensuring access to care. We then developed strategies to address these challenges.
Conclusion: In order for healthcare to transition into personalized medicine, it is necessary for stakeholders to build momentum by implementing a progression of strategies.

Source: here.

The white paper was built over separate sets of questions asked to providers, industry, and patients (Online Supplement 2.)  The questions are clipped below.

Supplementary Material 2
(Highlighted added)

Focus Group Discussion Questions:
Provider Focus Group

1.       What is necessary to ensure that providers understand personalized medicine concepts and are aware of, and willing to use, novel personalized medicine technologies as they are introduced into practice? What sources of information and types of evidence are most effective in communicating to providers about developments in, and encouraging adoption of, personalized medicine tools?

2.       Over the past few years, how has evidence required for utilization of personalized medicine products within your health center changed, if at all?

3.       Is the value of most personalized medicine products clear and demonstrable?  How does your organization define “value” in the context of personalized medicine approaches, or medical products in general, for use in clinical practice?

4.       How can we best integrate personalized patient data into a resource to enable providers to successfully use appropriate, precise, timely, and clinically actionable patient information to improve patient care, and also facilitate continuing research into not yet clinically actionable data points?

5.       What can the industry and other stakeholders do to better educate provider populations on the concept of personalized medicine?

Industry Focus Group

1.       Over the past few years, how has the environment related to the evidence required for reimbursement and clinical adoption of personalized medicine products developed by your company changed, if at all?

2.       What can the various stakeholders (industry, providers, payers) do to better educate provider and patient populations about personalized medicine?

3.       What is necessary to build recognition of the value of personalized medicine in a way that can facilitate uptake in health care delivery?   What are appropriate incentives to encourage greater uptake of personalized clinical decision-making by payers and providers?

4.       How can we better integrate personalized patient information into a resource that provides access to precise, timely, relevant patient information so that providers can utilize such information in their decision-making and patients can better understand and communicate their concerns?

5.       Is the value of most personalized medicine products demonstrable?  How does your organization define “value” in the context of personalized medicine approaches, or medical products in general, for use in clinical practice?

Patient Focus Group

1.       Over the past two years, has the environment changed relating to evidence and coverage of personalized medicine diagnostics affecting your patient population?
2.       Outside of issues of regulatory and reimbursement, what barriers are preventing access for patients in your constituency?
3.       What can the various stakeholders (industry, providers, payers) do to better educate patient populations on the concept of personalize medicine?
4.       How does your [patient] organization define “value” in the context of personalized medicine approaches, or medical products in general, for use in your patient population?
5.       Will increases in the affordability and availability of a patient’s genomic information empower patients to better their health or are you concerned that the complexity will confuse patients and result in inefficiencies in the system as they seek input from physicians?