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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
 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;
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
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
  1. Notes
  2. a Available through special request
  3. b HLA-B*15:02 screening is mandatory in Singapore. UGT1A*6 and UGT1A1*28 testing are available in National Cancer Centre
  4. c HLA-B*15:02 screening is routinely practised in major hospitals. A variety of other PGx testings are available as service in several university hospitals
  5. d BRCA screening is available in a few national/university/ specialised hospitals: University Malaya Medical Centre, Hospital Kuala Lumpur in Malaysia; National Cancer Centre Singapore, National University Hospital in Singapore
  6. e Next-generation sequencing is available in leading hospital: SingHealth-POLARIS in Singapore; Ramathibodi Hospital in Thailand
  7. f Some degree of ethical oversights are governed under the existing national medical genetics service and/or genetic testing guideline
  8. g Includes informed consent, security and confidentiality of information, and disclosure of test results to third parties outside direct healthcare providers
  9. h Genetic test is evaluated as medical device
  10. Abbreviations
  11. A*STAR Agency for Science and Technology Research, EHR electronic health record, GDP gross domestic product, GIS Genome Institute of Singapore, HTA health technology assessment, NR not reported or insufficient information, OOP out-of-pocket, PGx pharmacogenomics, PM personalized medicine, POLARIS Personalized OMIC Lattice for Advanced Research and Improving Stratification, PRISM SingHealth Duke-NUS Institute of Precision Medicine, SAPhIRE Surveillance and Pharmacogenomics Initiative for Adverse Drug Reactions, TCELS Thailand Centre of Excellence Life Sciences, THE total health expenditure, UKMMC University Kebangsaan Malaysia Medical Centre, UMBI UKM Medical Biology Institute, USD United States dollar