Abstract
Objectives
The introduction of Personalised Medicine (PM) into healthcare systems could benefit from a clearer understanding of the distinct national and regional frameworks around the world. Recent engagement by international regulators on maximising the use of real-world evidence (RWE) has highlighted the scope for improving the exploitation of the treasure-trove of health data that is currently largely neglected in many countries. The European Alliance for Personalised Medicine (EAPM) led an international study aimed at identifying the current status of conditions.
Methods
A literature review examined how far such frameworks exist, with a view to identifying conducive factors – and crucial gaps. This extensive review of key factors across 22 countries and 5 regions revealed a wide variety of attitudes, approaches, provisions and conditions, and permitted the construction of a comprehensive overview of the current status of PM. Based on seven key pillars identified from the literature review and expert panels, the data was quantified, and on the basis of further analysis, an index was developed to allow comparison country by country and region by region.
Results
The results show that United States of America is leading according to overall outcome whereas Kenya scored the least in the overall outcome.
Conclusions
Still, common approaches exist that could help accelerate take-up of opportunities even in the less prosperous parts of the world.
Funding source: PROMISE-Personalized Medicine Inquiry-Based Education Co-funded by the Erasmus+ Programme of the European Union, Grant Agreement No. 2019-1-HR01-KA203-061010.
Award Identifier / Grant number: 2019-1-HR01-KA203-061010.
Acknowledgments
Denis Horgan developed the concept, orientation, and overall narrative for this manuscript. A special thanks goes to Jaya Singh, Sanya Sethi, Anupriya Paul and Jonathan A. Lal for their contribution in data analysis and presenting the results. We would like to thank the members of the European Alliance for Personalised Medicine (EAPM), and the representatives of the European Commission and Member States for their kind input. All co-authors of this manuscript participated on roundtables organized by EAPM. We thank them all for their valuable and kind inputs. The organized panel was facilitated by sponsorship from Novartis, Astra Zeneca, MSD, Merck.
-
Research funding: This research received a grant from PROMISE-Personalized Medicine Inquiry-Based Education Co-funded by the Erasmus+ Programme of the European Union, Grant Agreement No. 2019-1-HR01-KA203-061010.
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: D.H. and M.K. are employees of the European Alliance for Personalised Medicine, which receives funding from both the public and private sectors. France Dube is an employee of Astra Zeneca. Amber Johns is a consultant to the ICGC ARGO project.
-
Informed consent: Not applicable.
-
Ethical approval: Not applicable.
References
1. ICMRA. ICMRA statement on international collaboration to enable real-world evidence (RWE) for regulatory decision-making; 2022. Available from: https://www.icmra.info/drupal/sites/default/files/2022-07/icmra_statement_on_rwe.pdf [Accessed 25 Jul 2022].Search in Google Scholar
2. ICMRA. A draft policy paper for ICMRA pharmacovigilance project; 2016. Available from: https://icmra.info/drupal/sites/default/files/2018-02/ICMRA%20PhV%20Big%20Data%20SubWG%20Policy%20Paper.pdf.Search in Google Scholar
3. European Commission. European health data space; 2022. Available from: https://health.ec.europa.eu/ehealth-digital-health-and-care/european-health-data-space_en [Accessed 25 Jul 2022].Search in Google Scholar
4. Jauregui, AE. Overview of the European health data space (EHDS): goals and current challenges. Eur J Publ Health 2021;31:ckab164.123. https://doi.org/10.1093/eurpub/ckab164.123. https://doi.org/10.1093/eurpub/ckab164.123.Search in Google Scholar
5. Shabani, M. Will the European Health Data Space change data sharing rules? Science 2022;375:1357–9. https://doi.org/10.1126/science.abn4874.Search in Google Scholar PubMed
6. Dash, S, Shakyawar, SK, Sharma, M, Kaushik, S. Big data in healthcare: management, analysis and future prospects. J Big Data 2019;6:54. https://doi.org/10.1186/s40537-019-0217-0.Search in Google Scholar
7. Gwinn, M, MacCannell, DR, Khabbaz, RF. Integrating advanced molecular technologies into public health. J Clin Microbiol 2017;55:703–14. https://doi.org/10.1128/jcm.01967-16.Search in Google Scholar PubMed PubMed Central
8. Burns, L, Le, RN, Kalesnik-Orszulak, R, Christian, J, Hukkelhoven, M, Rockhold, F, et al.. Real-world evidence for regulatory decision-making: guidance from around the world. Clin Therapeut 2022;44:420–37. https://doi.org/10.1016/j.clinthera.2022.01.012.Search in Google Scholar PubMed
9. Justo, N, Espinoza, MA, Ratto, B, Nicholson, M, Rosselli, D, Ovcinnikova, O, et al.. Real-world evidence in healthcare decision making: global trends and case studies from Latin America. Value Heal 2019;22:739–49. https://doi.org/10.1016/j.jval.2019.01.014.Search in Google Scholar PubMed
10. Hampson, G, Towse, A, Dreitlein, WB, Henshall, C, Pearson, SD. Real-world evidence for coverage decisions: opportunities and challenges. J Comp Eff Res 2018;7:1133–43. https://doi.org/10.2217/cer-2018-0066.Search in Google Scholar PubMed
11. Brixner, D, Biskupiak, J, Oderda, G, Burgoyne, D, Malone, DC, Arondekar, B, et al.. Payer perceptions of the use of real-world evidence in oncology-based decision making. J Manag Care Spec Pharm 2021;27:1096–105. https://doi.org/10.18553/jmcp.2021.27.8.1096.Search in Google Scholar PubMed
12. Burcu, M, Dreyer, NA, Franklin, JM, Blum, MD, Critchlow, CW, Perfetto, EM, et al.. Real-world evidence to support regulatory decision-making for medicines: considerations for external control arms. Pharmacoepidemiol Drug Saf 2020;29:1228–35. https://doi.org/10.1002/pds.4975.Search in Google Scholar PubMed PubMed Central
13. Frappe, E. Liquid biopsy technology – changing the paradigm in clinical diagnostics and IVD regulatory approaches; 2021. Available from: https://www.iqvia.com/blogs/2021/04/liquid-biopsy-technology-changing-the-paradigm-in-clinical-diagnostics-and-ivd-regulatory-approaches.Search in Google Scholar
14. Germann, S, Jasper, U. Realising the benefits of data driven digitalisation without ignoring the risks: health data governance for health and human rights. MHealth 2020;6:34. https://doi.org/10.21037/mhealth-2019-di-11.Search in Google Scholar PubMed PubMed Central
15. Batko, K, Ślęzak, A. The use of big data analytics in healthcare. J Big Data 2022;9:3. https://doi.org/10.1186/s40537-021-00553-4.Search in Google Scholar PubMed PubMed Central
16. Huang, BE, Mulyasasmita, W, Rajagopal, G. The path from big data to precision medicine. Expert Rev Precis Med Drug Dev 2016;1:129–43. https://doi.org/10.1080/23808993.2016.1157686.Search in Google Scholar
17. Hulsen, T, Jamuar, SS, Moody, AR, Karnes, JH, Varga, O, Hedensted, S, et al.. From big data to precision medicine. Front Med 2019;6:34. https://doi.org/10.3389/fmed.2019.00034.Search in Google Scholar PubMed PubMed Central
18. Shahbaz, M, Gao, C, Zhai, LL, Shahzad, F, Hu, Y. Investigating the adoption of big data analytics in healthcare: the moderating role of resistance to change. J Big Data 2019;6:6. https://doi.org/10.1186/s40537-019-0170-y.Search in Google Scholar
19. Brizmohun, N. Global regulators join hands to boost RWE use in decision-making; 2022. Available from: https://pink.pharmaintelligence.informa.com/PS146768/Global-Regulators-Join-Hands-To-Boost-RWE-Use-In-Decision-Making.Search in Google Scholar
20. Holland, S, Cawthra, J, Schloemer, T, Schröder-Bäck, P. Trust and the acquisition and use of public health information. Health Care Anal 2022;30:1–17. https://doi.org/10.1007/s10728-021-00436-y.Search in Google Scholar PubMed PubMed Central
21. Ostherr, K, Borodina, S, Bracken, RC, Lotterman, C, Storer, E, Williams, B. Trust and privacy in the context of user-generated health data. Big Data Soc 2017;4:1–11. https://doi.org/10.1177/2053951717704673.Search in Google Scholar
22. Peek, N, Rodrigues, PP. Three controversies in health data science. Int J Data Sci Anal 2018;6:261–9. https://doi.org/10.1007/s41060-018-0109-y.Search in Google Scholar PubMed PubMed Central
23. Zhao, D, Zha, H, Cleary, PD. Understanding the determinants of public trust in the health care system in China: an analysis of a cross-sectional survey. J Health Serv Res Pol 2019;24:135581961879911. https://doi.org/10.1177/1355819618799113.Search in Google Scholar PubMed
24. Tentori, M, Ziviani, A, Muchaluat-Saade, DC, Favela, J. Digital healthcare in Latin America: the case of Brazil and Mexico. Commun ACM 2020;63:72–7. https://doi.org/10.1145/3423923.Search in Google Scholar
25. Horgan, D, Borisch, B, Cattaneo, I, Caulfield, M, Chiti, A, Chomienne, C, et al.. Factors affecting citizen trust and public engagement relating to the generation and use of real-world evidence in healthcare. Int J Environ Res Publ Health 2022;19:1674. https://doi.org/10.3390/ijerph19031674.Search in Google Scholar PubMed PubMed Central
26. Li, M, Chen, S, Lai, Y, Liang, Z, Wang, J, Shi, J, et al.. Integrating real-world evidence in the regulatory decision-making process: a systematic analysis of experiences in the US, EU, and China using a logic model. Front Med 2021;8:669509. https://doi.org/10.3389/fmed.2021.669509.Search in Google Scholar PubMed PubMed Central
27. Monga, N, Garside, J, Quigley, J, O’Rourke, J, O’Donovan, P, Padhiar, A, et al.. Review of real-world evidence to assess the burden of illness of mantle cell lymphoma. Value Healh 2017;20:A469. https://doi.org/10.1016/j.jval.2017.08.401.Search in Google Scholar
28. Mateo, J, Steuten, L, Aftimos, P, André, F, Davies, M, Garralda, E, et al.. Delivering precision oncology to patients with cancer. Nat Med 2022;28:658–65. https://doi.org/10.1038/s41591-022-01717-2.Search in Google Scholar PubMed
29. Janssen, M, Brous, P, Estevez, E, Barbosa, LS, Janowski, T. Data governance: organizing data for trustworthy artificial intelligence. Govern Inf Q 2020;37:101493. https://doi.org/10.1016/j.giq.2020.101493.Search in Google Scholar
30. Horgan, D, Borisch, B, Richer, E, Bernini, C, Kalra, D, Lawler, M, et al.. Propelling health care into the twenties. Biomed Hub 2020;5:1–53. https://doi.org/10.1159/000508300.Search in Google Scholar PubMed PubMed Central
31. Aerd statistics. Spearman’s rank-order correlation using SPSS statistics; 2022. Available from: https://statistics.laerd.com/spss-tutorials/spearmans-rank-order-correlation-using-spss-statistics.php#:∼:text=The%20Spearman%20rank%2Dorder%20correlation,letter%20%CF%81%2C%20pronounced%20rho) [Accessed 16 Aug 2022].Search in Google Scholar
32. Cavazzoni, P. FDA takes steps to provide clarity on developing new drug product in the age of individualize medicine; 2021. Available from: https://www.fda.gov/news-events/press-announcements/fda-takes-steps-provide-clarity-developing-new-drug-products-age-individualized-medicine [Accessed 16 Aug 2022].Search in Google Scholar
33. WHO. WHO, WIPO, WTO to hold technical symposium on response, preparedness to future pandemics; 2022. Available from: https://www.who.int/news/item/10-11-2022-who–wipo–wto-to-hold-technical-symposium-on-response–preparedness-to-future-pandemics.Search in Google Scholar
34. OECD. Reviews of public health: Korea: a healthier tomorrow; 2022. Available from: https://www.oecd-ilibrary.org/sites/3b1ee34f-en/index.html?itemId=/content/component/3b1ee34f-en [Accessed 16 Aug 2022].Search in Google Scholar
35. Dayton, L. How South Korea made itself a global innovation leader. Nature 2020;581:S54–6. https://doi.org/10.1038/d41586-020-01466-7.Search in Google Scholar
36. Cho, HN, Shin, SY, Hwangbo, B, Chang, YJ. Views on precision medicine among health professionals in Korea: a mixed methods study. Yonsei Med J 2020;61:192–7. https://doi.org/10.3349/ymj.2020.61.2.192.Search in Google Scholar PubMed PubMed Central
37. Son, KB. Understanding the adoption of new drugs decided by several stakeholders in the South Korean market: a non-parametric event history analysis. Health Econ Rev 2018;8:34. https://doi.org/10.1186/s13561-018-0216-4.Search in Google Scholar PubMed PubMed Central
38. Kim, H, Kim, SY, Joly, Y. South Korea: in the midst of a privacy reform centered on data sharing. Hum Genet 2018;137:627–35. https://doi.org/10.1007/s00439-018-1920-1.Search in Google Scholar PubMed PubMed Central
39. Abicalaffe, A, Schafer, J. Opportunities and challenges of value-based health care: how Brazil can learn from U.S. Ex-Perience. J Manag Care Spec Pharm 2020;26:1172–5. https://doi.org/10.18553/jmcp.2020.26.9.1172.Search in Google Scholar PubMed
40. LEK. Structuring unstructured medical device reimbursement in India; 2021. Available from: https://www.lek.com/insights/ei/structuring-unstructured-medical-device-reimbursement-india.Search in Google Scholar
41. LEK. Unlocking the opportunities for companion diagnostics in Asia-pacific; 2019. Available from: https://www.lek.com/insights/ei/unlocking-opportunities-companion-diagnostics-asia-pacific.Search in Google Scholar
42. Ebi, H, Bando, H. Precision oncology and the universal health coverage system in Japan. JCO Precis Oncol 2019;3:1–12. https://doi.org/10.1200/po.19.00291.Search in Google Scholar
43. IQN Path. Unlocking the potential of precision medicine in Europe; 2021. Available from: https://ecpc.org/wp-content/uploads/2021/02/unlocking-the-potential-of-precision-medicine-in-europe-FULL-REPORT.pdf [Accessed 16 Aug 2022].Search in Google Scholar
44. Ortiz, I, Luna, A., pricing and reimbursement; 2018. Available from: https://pharmaboardroom.com/legal-articles/regulatory-pricing-and-reimbursement-mexico/ [Accessed 16 Aug 2022].Search in Google Scholar
45. Xi, K. Precision medicine in Asia: more regional cooperationed needed; 2020. Available from: https://pharmaboardroom.com/articles/precision-medicine-in-asia-regional-cooperation/ [Accessed 16 Aug 2022].Search in Google Scholar
46. Statista. Share of hospitals in Japan that implemented electronic medical records (EMR) as of October 2019; 2022. Available from: https://www.statista.com/statistics/1121012/japan-share-hospitals-electronic-health-record/ [Accessed 16 Aug 2022].Search in Google Scholar
47. Saffer, QA, Faith, TA, Alshehri, A, Mohammed, RA, Homidi, SA, Hamza, MM, et al.. The capacity of primary health care facilities in Saudi Arabia: infrastructure, services, drug availability, and human resources. BMC Health Serv Res 2021;21:365.10.1186/s12913-021-06355-xSearch in Google Scholar PubMed PubMed Central
48. Brivik, T. Who owns your health records in South Africa? 2015. Available from: https://www.hcsmsa.co.za/healthdatalaw/ [Accessed 16 Aug 2022].Search in Google Scholar
49. Fasseeh, A, Karam, R, Jameleddine, M, George, M, Kristensen, FB, Al-Rabayah, AA, et al.. Implementation of health technology assessment in the Middle East and North Africa: comparison between the current and preferred status. Front Pharmacol 2020;11:15. https://doi.org/10.3389/fphar.2020.00015.Search in Google Scholar PubMed PubMed Central
50. Katurura, MC, Cilliers, L. Electronic health record system in the public health care sector of South Africa: a systematic literature review. Afr J Prim Health Care Fam Med 2018;10:1–8. https://doi.org/10.4102/phcfm.v10i1.1746.Search in Google Scholar PubMed PubMed Central
51. Market Data Forecast. Middle East & Africa companion diagnostics market research report – segmented by indi-cation, by technology & by country (KSA, UAE, Israel, rest of GCC countries, South Africa, Ethiopia, Kenya, Egypt, Sudan, rest of MEA) – industry analysis on size, share, trends, COVID-19 impact & growth forecast (2021 to 2026); 2021. Available from: https://www.marketdataforecast.com/market-reports/mea-companion-diagnostics-market.Search in Google Scholar
52. Giles, J. Privacy and data protection in healthcare in South Africa; 2021. Available from: https://www.michalsons.com/blog/privacy-in-healthcare/8637 [Accessed 16 Aug 2022].Search in Google Scholar
53. Mulder, N. Development to enable precision medicine in Africa. Futur Med 2017;14:467–70. https://doi.org/10.2217/pme-2017-0055.Search in Google Scholar PubMed
54. USC Schaeffer. Health technology assessment for the U.S. healthcare system; 2020. Available from: https://healthpolicy.usc.edu/research/health-technology-assessment-for-the-u-s-healthcare-system/.Search in Google Scholar
55. Smit, M., pricing and reimbursement; 2018. Available from: https://pharmaboardroom.com/legal-articles/regulatory-pricing-and-reimbursement-south-africa/ [Accessed 16 Aug 2022].Search in Google Scholar
56. Kielstra, P., access and inequality in Latin America a tale of light and shadow; 2017. Available from: http://www.alatro.org/images/archivos/Cancer-control-access-LatinAmerica.pdf [Accessed 16 Aug 2022].Search in Google Scholar
57. GHI Team. Electronic medical records growing in Latin America; 2017. Available from: https://globalhealthintelligence.com/ghi-analysis/electronic-medical-records-growing-in-latin-america/ [Accessed 16 Aug 2022].Search in Google Scholar
58. Grimaldo, AAT. Personalised healthcare in Latin America-universalizing the promise of innovation; 2020. Available from: https://www.researchgate.net/publication/346061802_Personalised_Healthcare_in_Latin_America-_Universalising_the_promise_of_innovation.Search in Google Scholar
59. Market Data Forecast. Latin America companion diagnostics market research report – segmented by indication, by technology & by country (Mexico, Brazil, Argentina, Chile and rest of Latin America) – industry analysis, size, share, growth, trends, forecast (2021 to 2026); 2022. Available from: https://www.marketdataforecast.com/market-reports/mea-companion-diagnostics-market [Accessed 16 Aug 2022].Search in Google Scholar
60. Rosselli, D, Lazo, CQ, Csanadi, M, Castilla, EMR, Gonzalez, NC, Valdes, J, et al.. HTA implementation in Latin American countries: comparison of current and preferred status. Sci Dir 2017;14:20–7. https://doi.org/10.1016/j.vhri.2017.02.004.Search in Google Scholar PubMed
61. Chong, HY, Allotey, PA, Chaiyakunapruk, N. Current landscape of personalized medicine adoption and implementation in Southeast Asia. BMC Med Genom 2018;11:94. https://doi.org/10.1186/s12920-018-0420-4.Search in Google Scholar PubMed PubMed Central
62. Liu, J, Wu, EQ, Ahn, J, Kamae, I, Xie, J, Yang, H. The development of health technology assessment in Asia: current status and future trends. Sci Dir 2020;21:39–44. https://doi.org/10.1016/j.vhri.2019.08.472.Search in Google Scholar PubMed
63. Iqvia. Accelerating patient access to precision oncology in Asia-pacific; 2021. Available from: https://www.iqvia.com/-/media/iqvia/pdfs/asia-pacific/white-papers/accelerating-patient-access-to-precision-oncology-in-asia-pacific.pdf.Search in Google Scholar
64. PharmaBoardRoom. Precision medicine in Asia: more regional cooperation needed; 2020. Available from: https://pharmaboardroom.com/articles/precision-medicine-in-asia-regional-cooperation/.Search in Google Scholar
65. Hou, T, Le Deu, F, Shao, Y, Tian, J. Managing China’s growing oncology burden; 2020. Available from: https://www.mckinsey.com/industries/life-sciences/our-insights/managing-chinas-growing-oncology-burden [Accessed 16 Aug 2022].Search in Google Scholar
66. Pennell, NA, Arcila, ME, Gandara, DR, West, H. Biomarker testing for patients with advanced non–small cell lung cancer: real-world issues and tough choices. Am Soc Clin Oncol Educ Book 2019;39:531–42. https://doi.org/10.1200/edbk_237863.Search in Google Scholar
67. Chitale, A. Precision medicine and its impact on the global therapeutic landscape; 2019. Available from: https://pharmaboardroom.com/articles/precision-medicine-and-its-impact-on-the-global-therapeutic-landscape/ [Accessed 16 Aug 2022].Search in Google Scholar
68. Strasser-Weippl, K, Chavarri-Guerra, Y, Villarreal-Garza, C, Bychkovsky, BL, Debiasi, M, Liedke, PE, et al.. Progress and remaining challenges for cancer control in Latin America and the Caribbean. Lancet Oncol 2015;16:1405–38. https://doi.org/10.1016/S1470-2045(15)00218-1.10.1016/S1470-2045(15)00218-1Search in Google Scholar PubMed
69. Guerrero, C. Cancer preparedness in Latin America. The need to build on recent progress; 2019. Available from: https://worldcancerinitiative.economist.com/pdf/Roche-cancer-preparedness-in-latin-america/CANCER%20PREPAREDNESS%20IN%20LATAM.pdf [Accessed 16 Aug 2022].Search in Google Scholar
70. Torres-Grimaldo, AA. Personalised healthcare in Latin America universalizing the promise of innovation; 2020. Available from: https://www.researchgate.net/publication/346061802_Personalised_Healthcare_in_Latin_America-_Universalising_the_promise_of_innovation [Accessed 16 Aug 2022].Search in Google Scholar
71. Staff reporter. City of hope supporting precision oncology education efforts at Brazilian hospital; 2021. Available from: https://www.precisiononcologynews.com/business-news/city-hope-supporting-precision-oncology-education-efforts-brazilian-hospital#.YS5iu81R2M9 [Accessed 16 Aug 2022].Search in Google Scholar
72. Export.gov. Healthcare resource guide: Chile; 2019. Available from: https://2016.export.gov/industry/health/healthcareresourceguide/eg_main_108572.asp [Accessed 16 Aug 2022].Search in Google Scholar
73. Xu, J, Gao, X, Sorwar, G, Croll, P. Implementation of E-health record systems in Australia. Int Tech Manag Rev 2013;3:92–104. https://doi.org/10.2991/itmr.2013.3.2.3.Search in Google Scholar
74. Express News Service. Experts call for patients to access cancer treatment without delay despite Covid pandemic; 2020. Available from: https://indianexpress.com/article/cities/pune/experts-call-for-patients-to-access-cancer-treatment-without-delay-despite-covid-pandemic-7099910/ [Accessed 16 Aug 2022].Search in Google Scholar
75. Misra, SC, Bisui, S, Singh, A. A study on the role of trust factor in adopting personalised medicine. Tay Franc Onl 2020;39:771–87. https://doi.org/10.1080/0144929x.2019.1614225.Search in Google Scholar
76. Lee, SS, Salole, E. Medical device reimbursement coverage and pricing rules in Korea: current practice and issues with access to innovation. Value Health 2014;17:476–81. https://doi.org/10.1016/j.jval.2014.03.1719.Search in Google Scholar PubMed
77. Kwon, S. Patients can now access their health records online, but they may not understand them; 2021. Available from: https://www.latimes.com/science/story/2021-05-17/patients-can-access-health-data-online-on-demand-confusion [Accessed 16 Aug 2022].Search in Google Scholar
78. Komine, K, Shirota, H. Interinstitutional collaboration for molecular tumor Boards. Gan to kagaku ryoho 2019;46:626–9.Search in Google Scholar
79. Kim, H, Byrnes, J, Goodall, S. Health technology assessment in Australia: the pharmaceutical benefits advisory com-mittee and medical services advisory committee. PubMed 2021;24:6–11. https://doi.org/10.1016/j.vhri.2020.09.001.Search in Google Scholar PubMed
80. Patrone, J. Spanish government allocates €25M for precision and genomic medicine, data science; 2020. Available from: https://www.genomeweb.com/research-funding/spanish-government-allocates-25m-precision-and-genomic-medicine-data-science#.YRpQ2s1R2M9 [Accessed 16 Aug 2022].Search in Google Scholar
81. Badwaik, R. Precision medicine: emerging trends in cancer therapy. J Clin Diagn Res 2019;13:FE01–4. https://doi.org/10.7860/jcdr/2019/42394.13231.Search in Google Scholar
82. Biobanking. 10 largest biobanks in the world; 2021. Available from: https://www.biobanking.com/10-largest-biobanks-in-the-world/ [Accessed 16 Aug 2022].Search in Google Scholar
83. Burnel, P. The introduction of electronic medical records in France: more progress during the second attempt. Health Pol 2018;122:937–40. https://doi.org/10.1016/j.healthpol.2018.07.022.Search in Google Scholar PubMed
84. CancerNet. Financial resources; 2021. Available from: https://www.cancer.net/navigating-cancer-care/financial-considerations/financial-resources [Accessed 16 Aug 2022].Search in Google Scholar
85. Chambers and, Partners. Artificial intelligence 2022; 2022. Available from: https://practiceguides.chambers.com/practice-guides/comparison/861/9017/14155-14157-14159-14162-14165-14169-14172-14174-14180-14184-14186-14188-14190-14192 [Accessed 16 Aug 2022].Search in Google Scholar
86. Ciampi, M, Esposito, A, Guarasci, R, Pietro, GD. Towards interoperability of EHR systems: the case of Italy. ICT4AWE 2016;1:133–8.10.5220/0005916401330138Search in Google Scholar
87. Canadian Institutes of Health Research. Funding decisions database; 2022. Available from: https://webapps.cihr-irsc.gc.ca/decisions/p/main.html?lang=en#fq={!tag=allText}acallText%3A201906ENP&sort=namesort%20asc&start=0&rows=20 [Accessed 16 Aug 2022].Search in Google Scholar
88. Diez, IDT, Gonzalez, S, Coronado, ML. EHR systems in the Spanish public health national system: the lack of in-teroperability between primary and specialty care. PubMed 2013;37:9914.10.1007/s10916-012-9914-3Search in Google Scholar
89. Ecipe Working Paper. Restrictions on cross-border data flows: a taxonomy; 2017. Available from: https://ecipe.org/wp-content/uploads/2017/11/Restrictions-on-cross-border-data-flows-a-taxonomy-final1.pdf.Search in Google Scholar
90. Fundación Instituto Roche. Proposal of recommendations for a personalised precision medicine national strategy; 2017. Available from: https://www.institutoroche.es/static/pdfs/Propuesta_de_Recomendaciones_MPP_INGLES.pdf.Search in Google Scholar
91. Garrido, P, Aldaz, A, Vera, R, Calleja, MA, Álava, ED, Martín, M, et al.. Proposal for the creation of a national strategy for precision medicine in cancer: a position statement of SEOM, SEAP, and SEFH. Clin Transl Oncol 2018;20:443–7. https://doi.org/10.1007/s12094-017-1740-0.Search in Google Scholar PubMed PubMed Central
92. Xifin. How will reimbursement be managed in the era of precision medicine and value-based care? 2019. Available from: https://www.xifin.com/resources/blog/201903/how-will-reimbursement-be-managed-era-precision-medicine-and-value-based-care.Search in Google Scholar
93. Grand View, Research. Oncology companion diagnostic market size, share & trends analysis report by product & service, by technology (IHC, NGS), by disease type (breast cancer, leukemia), by end-use, by region, and segment forecasts, 2020 – 2027; 2020. Available from: https://www.grandviewresearch.com/industry-analysis/oncology-companion-diagnostics-market.Search in Google Scholar
94. Hartman, HE, Sun, Y, Devasia, TP. Integrated survival estimates for cancer treatment delay among adults with cancer during the COVID-19 pandemic. JAMA Oncol 2020;6:1881–9. https://doi.org/10.1001/jamaoncol.2020.5403.Search in Google Scholar PubMed PubMed Central
95. ICLG. Data protection laws and regulations; 2022. Available from: https://iclg.com/practice-areas/data-protection-laws-and-regulations/spain [Accessed 16 Aug 2022].Search in Google Scholar
96. Lexology. Germany prepares new law for patient data protection and increased digitalization in healthcare and for “data donations” for research purposes; 2020. Available from: https://www.lexology.com/library/detail.aspx?g=e042656c-5c9c-4b11-a9c0-97cd1ca18d7e.Search in Google Scholar
97. The Commonwealth Fund. What is the status of electronic health records? 2020. Available from: https://www.commonwealthfund.org/international-health-policy-center/system-features/what-status-electronic-health-records [Accessed 16 Aug 2022].Search in Google Scholar
98. HumanApi. The current state of electronic health record (EHR) dana access; 2022. Available from: https://www.humanapi.co/health-data-innovation-blog/the-current-state-of-ehr-data-access.Search in Google Scholar
99. Healthcare Industry, BW.: digital records in the German healthcare system; 2019. Available from: https://www.gesundheitsindustrie-bw.de/en/article/news/ehr-and-phr-digital-records-in-the-german-healthcare-system.Search in Google Scholar
100. Pinsent Masons. GDPR guidance issued for health bodies in Spain; 2019. Available from: https://www.pinsentmasons.com/out-law/analysis/gdpr-guidance-issued-for-health-bodies-in-spain.Search in Google Scholar
101. PMF. Innovation in Italy; 2020. Available from: https://www.pmf-research.eu/en/innovation-in-italy-in-2020/ [Accessed 16 Aug 2022].Search in Google Scholar
102. Coos, A. Data protection in Canada: all you need to know about PIPEDA; 2019. Available from: https://www.endpointprotector.com/blog/data-protection-in-canada-pipeda/.Search in Google Scholar
103. Canadian Breast Cancer Network. Living with Breast Cancer; 2022. Available from: https://www.cbcn.ca/en/Facing_Financial_Issues [Accessed 16 Aug 2022].Search in Google Scholar
104. Cancer Council Wa. How we protect your data; 2022. Available from: https://cancerwa.asn.au/news/how-we-protect-your-data/ [Accessed 16 Aug 2022].Search in Google Scholar
105. CancerNet. Cancer in my community: Providing free access to cancer care in Saudi Arabia; 2020. Available from: https://www.cancer.net/blog/2020-09/cancer-my-community-providing-free-access-cancer-care-saudi-arabia [Accessed 16 Aug 2022].Search in Google Scholar
106. Cardoso, F, Wilking, N, Bernardini, R, Biganzoli, L, Espin, J, Miikkulainen, K. A multi-stakeholder approach in optimizing patients’ needs in the benefit assessment process of new metastatic breast cancer treatments. Science Direct 2020;52:78–87. https://doi.org/10.1016/j.breast.2020.04.011.Search in Google Scholar PubMed PubMed Central
107. FDA. FDA takes steps to provide clarity on developing new drug products in the age of individualized medicine; 2021. Available from: https://www.fda.gov/news-events/press-announcements/fda-takes-steps-provide-clarity-developing-new-drug-products-age-individualized-medicine.Search in Google Scholar
108. Kichko, K, Marschall, P, Flessa, S. Personalized medicine in the U.S. and Germany: awareness, acceptance, use and preconditions for the wide implementation into the medical standard. J Personalized Med 2016;6:15. https://doi.org/10.3390/jpm6020015.Search in Google Scholar PubMed PubMed Central
109. Leonard, K. White house details ‘precision medicine’ initiative; 2015. Available from: https://www.usnews.com/news/articles/2015/01/30/white-house-details-precision-medicine-initiative [Accessed 16 Aug 2022].Search in Google Scholar
110. WHO. The global healthobservatory; 2022. Available from: https://www.who.int/data/gho/publications/world-health-statistics [Accessed 16 Aug 2022].Search in Google Scholar
111. Almuammar, A. Primary health care factors associated with late presentation of cancer in Saudi Arabia. J Radiother Pract 2019;19:71–5. https://doi.org/10.1017/s1460396919000232.Search in Google Scholar
112. Barasa, LKM, Greene, S, Abinya, NAO, Wheeler, SB, Skinner, A, Bennett, AVA. Review of Kenya’s cancer policies to improve access to cancer testing and treatment in the country. BioMedCentral 2020;18:2.10.1186/s12961-019-0506-2Search in Google Scholar
113. Barasa, LKM, Greene, S, Abinya, NAO, Wheeler, SB, Skinner, A, Bennett, AV. Improving access to cancer testing and treatment in Kenya. J Glo Onc 2017;4:1–8.10.1200/JGO.2017.010124Search in Google Scholar
114. PNO. Innovation funding trends for personalized medicine; 2017. Available from: https://www.pnoconsultants.com/wp-content/uploads/2017/09/Epaper-Personalized-Medicine-by-PNO.pdf.Search in Google Scholar
115. Brich, S, Alsayed, T, Ansari, A, Malik, EH, Herod, J. 465 Delays in treatment in gynaecology oncology patients in Qatar seeking management overseas. Int J Gynecol Cancer 2020;30:A192.10.1136/ijgc-2020-IGCS.403Search in Google Scholar
116. Dewik, NIA, Qoronfleh, MW. Genomics, precision medicine: molecular diagnostics innovations shaping the future of healthcare in Qatar. Adv Public Health 2019;2019:1–11.10.1155/2019/3807032Search in Google Scholar
117. Elmagd, MA, Assisi, M, Schulten, HJ, Dallol, A, Pushparaj, PN, Ahmed, F, et al.. Individualized medicine enabled by genomics in Saudi Arabia. BMC Med Genom 2015;8(1 Suppl):S3.10.1186/1755-8794-8-S1-S3Search in Google Scholar PubMed PubMed Central
118. Elsayed, O. Data protection in the kingdom of Saudi Arabia: a primer; 2013. Available from: https://www.globalprivacyblog.com/privacy/data-protection-in-the-kingdom-of-saudi-arabia-a-primer/ Search in Google Scholar
119. Fosci, M, Loffreda, L, Chamberlain, A, Naidoo, N. Assessing the needs of the research system in Kenya. Report for the SRIA programme; 2019. Available from: https://assets.publishing.service.gov.uk/media/5ef4acb5d3bf7f7145b21a22/NA_report_Kenya__Dec_2019_Heart_.pdf [Accessed 17 Aug 2022].Search in Google Scholar
120. Global, Giving. Medical emergency cancer fund for Kenya; 2022. Available from: https://www.globalgiving.org/projects/medical-emergency-cancer-fund-for-kenya/ [Accessed 17 Aug 2022].10.5089/9798400215339.002Search in Google Scholar
121. Hasanain, RA, Vallmuur, K, Clark, M. Electronic medical record systems in Saudi Arabia: knowledge and preferences of healthcare professionals; 2015. Available from: https://www.jhidc.org/index.php/jhidc/article/view/135.Search in Google Scholar
122. Hulsen, T. Sharing is caring—data sharing initiatives in healthcare. Int J Environ Res Publ Health 2020;17:3046. https://doi.org/10.3390/ijerph17093046.Search in Google Scholar PubMed PubMed Central
123. Ewumi, O. How can big data, RWD, and RWE upgrade healthcare in Africa? 2021. Available from: https://www.the-yuan.com/89/How-Can-Big-Data-RWD-and-RWE-Upgrade-Healthcare-in-Africa.html.Search in Google Scholar
124. Inan, OT, Tenaerts, P, Prindiville, SA, Reynolds, HR, Dizon, DS, Cooper-Arnold, K, et al.. Digitizing clinical trials. NPJ Digit Med 2020;3:101. https://doi.org/10.1038/s41746-020-0302-y.Search in Google Scholar PubMed PubMed Central
125. Costa, L, Hincapie, AL, Gilardino, R, Tang, B, Julian, G, Soares, CS, et al.. PNS118 real world evidence (RWE) use in Latin America healthcare decision making: an stakeholder survey analysis; 2021. Available from: https://www.ispor.org/docs/default-source/intl2021/pdfispor-ipostersessions–-an-amuze-interactive-system-pdf.pdf?sfvrsn=aec9d922_0.10.1016/j.jval.2021.04.970Search in Google Scholar
126. Alves, D, Yamada, DB, Bernardi, FA, Carvalho, I, Colombo Filho, ME, Neiva, MB, et al.. Mapping, infrastructure, and data analysis for the Brazilian network of rare diseases: protocol for the RARASnet observational cohort study. JMIR Res Protoc 2021;10:e24826. https://doi.org/10.2196/24826.Search in Google Scholar PubMed PubMed Central
127. OECD. Health data infrastructure and information system in Brazil; 2021. Available from: https://www.oecd-ilibrary.org/sites/b601203f-en/index.html?itemId=/content/component/b601203f-en.Search in Google Scholar
128. Lopez, SM. Transforming Chile’s health sector with connectivity; 2017. Available from: https://www.blog.google/topics/google-cloud/transforming-chiles-health-sector-connectivity/.Search in Google Scholar
129. Diaz, A, Ortiz Munoz, I. Digital health 2022-Mexico; 2021. Available from: https://www.mondaq.com/mexico/healthcare/1169098/digital-health-2022.Search in Google Scholar
130. Ho, C. MS26.02 translation of clinical data to real world – North America. J Thorac Oncol 2018;13:S296–7. https://doi.org/10.1016/j.jtho.2018.08.190.Search in Google Scholar
131. Rodriguez-Ferrand, G.: law creating interoperable electronic health records system enacted. The Library of Congress; 2020. Available from: https://www.loc.gov/item/global-legal-monitor/2020-03-09/colombia-law-creating-interoperable-electronic-health-records-system-enacted.Search in Google Scholar
132. Lou, J, Kc, S, Toh, KY, Dabak, S, Adler, A, Ahn, J, et al.. Real-world data for health technology assessment for reimbursement decisions in Asia: current landscape and a way forward. Int J Technol Assess Health Care 2020;36:474–80. https://doi.org/10.1017/s0266462320000628.Search in Google Scholar PubMed
133. Böttinger, E. Big health data, big health opportunities; 2019. Available from: https://hpi.de/fileadmin/hpi/Forschung/Publikationen/HealthReport_Japan_Boettinger.pdf.Search in Google Scholar
134. Cabral, EI. The philippine health agenda for 2016 to 2022. Philippine J Intern Med 2016;54:1–11.Search in Google Scholar
135. World Economic Forum. Why the most important tool in healthcare is trust; 2019. Available from: https://www.weforum.org/agenda/2019/08/important-tool-in-healthcare-is-trust-vaccines-africa/.Search in Google Scholar
136. Cookiebot. POPIA – South Africa’s protection of personal information act | enforcement update July; 2021. Available from: https://www.cookiebot.com/en/popia/.Search in Google Scholar
137. Council of Europe. Instance nationale de protection des données à caractère personnel (INPDP); 2022. Available from: https://www.coe.int/fr/web/tunis/inpdp [Accessed 25 Jul 2022].Search in Google Scholar
138. Adeniran, A. Developing an effective data governance framework to deliver African digital potentials; 2022. Available from: https://www.brookings.edu/blog/africa-in-focus/2022/03/21/developing-an-effective-data-governance-framework-to-deliver-african-digital-potentials/ [Accessed 25 Jul 2022].Search in Google Scholar
139. Osakwe, S, Adeniran, A. Strengthening data governance in Africa; 2021. Available from: https://cseaafrica.org/wp-content/uploads/2021/08/Strengthening-Regional-Data-Governance-in-Africa-1.pdf.Search in Google Scholar
140. ICH. Final concept paper establishment of a new ICH guideline on “General principles on plan, design, and analysis of pharmacoepidemiological studies that utilize real-world data for safety assessment of medicines”; 2022. Available from: https://database.ich.org/sites/default/files/M14_ConceptPaper_2022_0405.pdf [Accessed 25 Jul 2022].Search in Google Scholar
141. Austin, E, Lee, JR, Amtmann, D, Bloch, R, Lawrence, SO, McCall, D, et al.. Use of patient-generated health data across healthcare settings: implications for health systems. JAMIA Open 2019;3:70–6. https://doi.org/10.1093/jamiaopen/ooz065.Search in Google Scholar PubMed PubMed Central
142. Heijlen, R, Crompvoets, J. Open health data: mapping the ecosystem. Digit Heal 2021;7:20552076211050167. https://doi.org/10.1177/20552076211050167.Search in Google Scholar PubMed PubMed Central
143. Peng, C, Goswami, P, Bai, G. A literature review of current technologies on health data integration for patient-centered health management. Health Inf J 2020;26:1926–51.10.1177/1460458219892387Search in Google Scholar PubMed
144. Efpia. Position on a European health data space; 2020. Available from: https://www.efpia.eu/publications/downloads/efpia/position-on-a-european-health-data-space/.Search in Google Scholar
145. Genovese, S, Bengoa, R, Bowis, J, Harney, M, Hauck, B, Pinget, M, et al.. The European Health Data Space: a step towards digital and integrated care systems. J Integrated Care 2022;30:363–72. https://doi.org/10.1108/jica-11-2021-0059.Search in Google Scholar
146. WHO. WHO director-general declares the ongoing monkeypox outbreak a public health emergency of international concern; 2022. Available from: https://www.who.int/europe/news/item/23-07-2022-who-director-general-declares-the-ongoing-monkeypox-outbreak-a-public-health-event-of-international-concern [Accessed 25 Jul 2022].Search in Google Scholar
147. EMA. EMA response to the monkeypox public health emergency; 2022. Available from: https://www.ema.europa.eu/en/news/ema-response-monkeypox-public-health-emergency [Accessed 25 Jul 2022].Search in Google Scholar
© 2022 Walter de Gruyter GmbH, Berlin/Boston