Friday , January 22 2021

Education: Costa Rica with personalized medicine practice conditions


The research report “Personalized medicine in Latin America: Universalizing the promise of innovation” by The Economist’s Intelligence Unit (EIU, for its abbreviation in English), Costa Rica has the necessary conditions for adopting a personalized healthcare approach. Despite some difficulties awaiting its goal of affecting the entire population; It also underlines that it is the Central American country with the best social, political, economic and health conditions for its implementation.

To contribute to greater and better local coverage, The study proposes the establishment of an initial reference framework covering governance, awareness and attitudes. Infrastructure and financial management issues where patients, medical community and health authorities understand the possibilities and challenges of personalized medicine in aspects such as patient and physician education, advances in digital and laboratory infrastructure, transition to medical advances, and more.

The study had the support of Roche Latin America and included Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Peru and Uruguay as well as Costa Rica.. Nine countries were categorized as first, second or third based on their assessment of the key elements required for the successful implementation of personalized medicine and where they were in this process.

The report places Costa Rica, Argentina, Brazil, Colombia and Uruguay at the top level, which it sees as “ready to make decisions” as they have important elements of the reference framework but have significant gaps in evaluation. At this level, Costa Rica is the country of Central America best prepared to decide whether to establish a comprehensive approach that encompasses the entire health system, not separate initiatives that allow to accompany each patient on their journey, from prevention to treatment and monitoring. determine your needs.

Personalized medicine: national progress

“Personalized medicine is based on molecular knowledge and the use of large-scale data; This enables them to respond to the individual needs of patients, improve the diagnosis and treatment of their disease, and cure with precise treatment decisions to achieve more effective results. honest; Strengthening healthcare systems through efficient use of resources and supporting their long-term sustainability, ”said Dr Roche Central America and Caribbean medical director. María Clara Horsburgh.

Medical advances, technology, genomics and data science, in addition to the potential to improve clinical outcomes for patients, enable health ecosystems to make data-driven decisions and resources.

The EIU study estimates that around 50 million people worldwide are using health apps on mobile phones (mHealth) for self-assessment. In the case of Costa Rica, all patients in the healthcare system have their own mobile app, Unique Digital Health Record (EDUS). On the other hand, the analysis emphasizes that the country has extensive experience in telemedicine dating back to 1994.

There are 61% of users with digital medical records in the country, within a legal framework that protects the confidentiality of their data. In 2017, the Organization for Economic Co-operation and Development (OECD) found that only 10 of the 28 member countries it studied had electronic health record agreements that could be described as excellent health information supporting quality, efficiency and reliability. performance of health systems.

According to EIU research, to embrace personalized medicine, countries include value-based care models, digitalization of health (including electronic medical records), real-world evidence incorporation into regulatory processes, and Health Technology Assessment (ETS). In this sense, there is no single unified HTA body at the local level, but rather a Committee of multiple agencies. The research highlights that the quality is variable, although the number of laboratories is probably sufficient for a country of this size.

Policies regarding personalized medicine exist and are widespread. In Costa Rica, the health system is developing initiatives such as the National Genomic Data System, Neonatal Screening Program, and the National Uterine Cancer Program.; What’s more, it hosts some personalized initiatives, but not for all the circumstances in which they are available. This transition involves much more than adopting new treatments as they are discovered.

Dr. As explained by Horsburgh, in complex therapeutic areas such as Oncology and Rare Diseases, personalized medicine provides better risk management and tailored care plans, as well as early and accurate diagnosis. “At the country level, cancer registries expand their scope by documenting their types and number of cases; It also has records of its entire population, but these are specific to birth diseases, not all rare diseases. “

Despite these advances, there is no substantial debate on the application of personalized cancer treatments or research in regional cancer control plans. In fact, the report shows that only 11 of the genetic mutations in any cancer in 2017 had associated and approved treatments. For the sake of society, developments are happening at a rapid pace: 42% of drugs approved by the U.S. Food and Drug Administration (FDA for English abbreviation) in 2018 could be classified as precision medicine.

Interventions to accelerate the adoption and access of sensitive medicine should be expressed among pharmaceutical companies, the State, professionals, patients., inter alia, and under the principles of Science, Ethics and rationality of resource use, but where outcome and patient satisfaction prevail, people as personal interests are not focused on treating illnesses.

According to the results of the report, public understanding, political will, better scientific infrastructure and effective health technology assessment can ensure not only the adoption of personalized medicine, but also the evolution of health systems towards comprehensive solutions for benefit. of the patient.

We are at a fundamental moment to articulate the different sectors of the healthcare ecosystem to build the framework that supports the adoption of personalized medicine together. This includes changes in health system governance, stakeholders’ technology knowledge, development of infrastructure that can generate a variety of personalized interventions, and corporate management that provides access to the best elements of personalized medicine. so that every patient gets the correct diagnosis and treatment on time ”. Dr. Horsesburgh

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