Table 2 Current PM adoption in four focus SEA countries based on six key themes
From: Current landscape of personalized medicine adoption and implementation in Southeast Asia
Key themes | Indicators | Indonesia | Malaysia | Singapore | Thailand |
|---|---|---|---|---|---|
Healthcare system | General | ||||
 GDP per capita (Current USD) | 3500 | 11,306 | 56,007 | 5970 | |
 Healthcare financing system | Social health insurance | Tax-funded | Mixture from tax revenue, insurer and patient | Social health insurance | |
 Healthcare expenditure per capita (USD) | 99 | 456 | 2752 | 360 | |
 THE (% of GDP, 2014) | 2.8 | 4.2 | 4.9 | 6.5 | |
 Health coverage (%) | 48 | 100 | 100 | 98 | |
 OOP health expenditure (% of THE, 2014) | 46.9 | 35.3 | 54.8 | 7.9 | |
PM-specific | |||||
 Presence of PM-related healthcare service delivery | |||||
  1. Targeted oncology therapy | Yes | Yes | Yes | Yes | |
  2. PGx testing | Noa | Noa | Yesb | Yesc | |
  3. Newborn screening | Yes (congenital hypothyroidism) | Yes (congenital hypothyroidism, G6PD) | Yes (congenital hypothyroidism, G6PD, inherited metabolic disorders) | Yes (congenital hypothyroidism, thalassemia, phenylketonuria) | |
  4. Cancer risk screening | Noa | Yesd | Yesd | Noa | |
  5. Advance genome sequencing | No | No | Yese | Yese | |
 Presence of PM-related healthcare workforce | |||||
  1. Medical geneticist | Yes (NR) | Yes (9) | Yes (6 + 2 cancer geneticist) | Yes (11) | |
  2. Genetic counsellors | Yes (NR) | Yes (2) | Yes (≈10) | No | |
 Financing mechanism | |||||
  1. Capacity-building | NR | NR | NR | NR | |
  2. Infrastructure | NR | NR | NR | NR | |
  3. Research | Cyclic grants from government, university, international collaborators | Cyclic, one-off grant from government, university | Funding from A*STAR | Cyclic, one-off grant from government, university | |
Governance | National strategy/plan | No | No | National PM initiative (in progress) | No |
Comprehensive PM legislation/guideline | No | Nof | Nof | No | |
Ethical, social, legal framework on PM provision | No | No | PM-specific provision standard is in progress | No | |
Ethical, social, legal framework for genetic data | No | Yes, but no laws related to genetic discrimination by insurance companies | PM-specific standard is in progressg | Yes, but no laws related to genetic discrimination by insurance companies | |
National PM research centre or large-scale research initiative | No | No | GIS; POLARIS; SAPhIRE; PRISM | PGx projects by TCELS | |
Direct to consumer test legislation or code of conduct | No | No | Bioethics Advisory Committee recommendations | Existing consumer law | |
PM working group with multiple stakeholders | No | No | Yes | Yes | |
Access | HTA body | Yes Major hospitals | Yes National | Yes National | Yes National |
PM-specific HTA framework | No | No | Noh | No | |
Multi-stakeholder decision-making group | Yes | Yes | Yes | Yes | |
Awareness | Patient support/advocacy groups | No | Yes | Yes, but not specific | Yes, but not specific |
Efforts to increase public awareness | Yes | Yes | Yes | Yes | |
Patient involvement in healthcare and/or research | Low in research | Low in research | Moderate in research | High in research | |
Implementation | Centre of excellence/leading institute in PM service | Dr Cipto Mangunkusumo Hospital; Center for Biomedical Research in Diponegoro University | Institute of Medical Research | PRISM | Ramathibodi Hospital; Khon Kaen University Hospital; Siriraj Hospital |
Education and training for PM and non-PM specialized healthcare workforce including medical school | Yes | Yes | Yes | Yes | |
Data | EHR | No | No | Yes | Yes |
Biobank | Hospital-level biobanks | Malaysian Cohort Biobank; UKMMC-UMBI Biobank | SingHealth Tissue Repository; National University Health System Tissue Repository | Hospital-level biobanks | |
Database | Indonesian National Genetic Database | Malaysian Human Variome Project | Singapore Genome Variation Project database; Singapore Human Mutation/ Polymorphism Database; Singapore PGx Portal | Thailand Mutation and Variation database | |
Patient registry with genetic/genomic data | No | Thalassemia Registry | Singapore Polyposis Registry; Thalassemia Registry; National Birth Defect Registry | No | |