An Index of Barriers for the Implementation of Personalised Medicine and Pharmacogenomics in Europe
Abstract
Background: Personalised medicine (PM) is an innovative way to produce better patient outcomes by using an individualised or stratified approach to disease and treatment rather than a collective treatment approach for patients. Despite its tangible advantages, the complex process to translate PM into the member states and European healthcare systems has delayed its uptake. The aim of this study is to identify relevant barriers represented by an index to summarise challenging areas for the implementation of PM in Europe. Methods: A systematic literature review was conducted, and a gaps-and-needs assessment together with a strengths-weaknesses-opportunities-and-threats analysis were applied to review strategic reports and conduct interviews with key stakeholders. Furthermore, surveys were sent out to representatives of stakeholder groups. The index was constructed based on the priorisation of relevant factors by stakeholders. Results: A need for stakeholder-agreed standards at all levels of implementation of PM exists, from validating biomarkers to definitions of ‘informed consent'. The barriers to implement PM are identified in 7 areas, namely, stakeholder involvement, standardisation, interoperable infrastructure, European-level policy making, funding, data and research, and healthcare systems. Conclusions: Challenges in the above-mentioned areas can and must be successfully tackled if we are to create a healthier Europe through PM. In order to create an environment in which PM can thrive for the patients' best outcomes, there is an urgent need for systematic actions to remove as many barriers as possible.
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In Europe, precision medicine is considered by researchers, healthcare providers and patient representatives to have limited availability because only a few programs are already in place.
“In Europe as well, where healthcare is primarily funded through government-regulated public health insurance systems, taxpayers and private insurance policies [111, 112], PM is considered by researchers, healthcare providers and patient representatives to have limited availability. This is because only a few programs are already in place. [58].”
From Patients’ and professionals’ views related to ethical issues in precision medicine: a mixed research synthesis (2021) · cites this paper as [58]
Many health care providers need further education in precision medicine or genomic medicine.
“These and other studies [37, 44–47, 58, 86, 105–108] reveal the need for further education of many health care providers, however, this requirement may vary between professionals in different fields [53, 81].”
From Patients’ and professionals’ views related to ethical issues in precision medicine: a mixed research synthesis (2021) · cites this paper as [58]
Interpreting multiomics, clinical and lifestyle data becomes complicated by inadequate validation of biomarkers and insufficient evidence of clinical utility, which leads to clinical uncertainty.
“However, interpreting multiomics, clinical and lifestyle data becomes complicated by inadequate validation of biomarkers and insufficient evidence of clinical utility, which leads to clinical uncertainty [58].”
From Patients’ and professionals’ views related to ethical issues in precision medicine: a mixed research synthesis (2021) · cites this paper as [58]
A study from Europe reports a certain reluctance on the part of health insurers to cover the costs for PM, as the evidence is insufficient and incentives too small.
“And indeed a study from Europe reports a certain reluctance on the part of health insurers to cover the costs for PM, as the evidence is insufficient and incentives too small [58].”
From Patients’ and professionals’ views related to ethical issues in precision medicine: a mixed research synthesis (2021) · cites this paper as [58]
Cited by
Sorted by citations
Erdmann, A., Rehmann-Sutter, C., & Bozzaro, C. (2021) · BMC Medical Ethics · doi:10.1186/s12910-021-00682-8 · Cited by 86 · see citing works
Personalized medicine in Europe: not yet personal enough?
Di Paolo, A., Sarkozy, F., Ryll, B., & Siebert, U. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2205-4 · Cited by 54 · see citing works
“assessments of drugs and CDs are often conducted separately, and fail to capture the full benefits of these products [28, 45].”
BackgroundKichko, K., Marschall, P., & Flessa, S. (2016) · Journal of Personalized Medicine · doi:10.3390/jpm6020015 · Cited by 36 · see citing works
Patient and interest organizations’ views on personalized medicine: a qualitative study
Budin-Ljøsne, I., & Harris, J. R. (2016) · BMC Medical Ethics · doi:10.1186/s12910-016-0111-7 · Cited by 32 · see citing works
“However, with the exception of recent surveys in which patient organizations identified potential barriers in PM implementation [9] and key priority areas within cancer [10], little empirical data are available to * Correspondence: i.”
BackgroundMalentacchi, F., Mancini, I., Brandslund, I., Vermeersch, P., Schwab, M., Marc, J., van Schaik, R. H. N., Siest, G., Theodorsson, E., Pazzagli, M., et al. (2015) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2015-0171 · Cited by 16 · see citing works
- Authors
- Horgan, D., Jansen, M., Leyens, L., Lal, J. A., Sudbrak, R., Hackenitz, E., Bußhoff, U., Ballensiefen, W., & Brand, A.
- Affiliations
- Maastricht University (NL)
- Max Planck Institute for Molecular Genetics (DE)
- ZonMw, The Dutch Organisation for knowledge and innovation in health, healthcare and well-being (NL)
- Deutsches Zentrum für Luft- und Raumfahrt e. V. (DLR) (DE)
- ORCID
- Venue
- Public Health Genomics
- Publisher
- S. Karger AG
- Published
- 2014
- Volume
- 17
- Issue
- 5-6
- Pages
- 287-298
- ISSN
- 1422-2795 (ISSN-L)
- 1662-4246
- 1662-8063
- OpenAlex
- W2042621864
- Cited by
- 91
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 10 · 2022: 8 · 2021: 6 · 2020: 11 · 2019: 1 · 2018: 14 · 2017: 18 · 2016: 12 · 2015: 4
- FWCI
- 13.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Public Health Genomics (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Seventh Framework Programme
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Keywords
- personalized medicine, pharmacogenomics, implementation barriers, European health systems, stakeholder engagement, standardization, biomarker validation, informed consent, health policy, funding, health care system
- MeSH terms
- Attitude to Health, Data Collection, Delivery of Health Care, Europe, Female, Genetic Markers, Humans, Pharmacogenetics, Policy Making, Public Policy, Public Health Practice, Precision Medicine
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