A national framework for transition to precision medicine

Abstract

Precision medicine (PM) is transforming healthcare by offering tailored interventions that address individual variability, transforming patient care and outcomes. PM is based on providing health-oriented services according to genetic characteristics, individual and family medical history, lifestyle, place of residence, and other personalized characteristics. This study aims to establish an appropriate framework for implementing PM in Iran. First, the global transition framework to PM was drawn by a systematic review, and then a framework for transition to PM in Iran was drawn by a case study through semi-structured interviews, an expert panel, and an analytic hierarchy process (AHP) questionnaire. The statistical sample of the study comprised PM specialists, researchers, and patients whose PM plays a significant role in their diagnosis and treatment. The sampling method was non-random with a combination of purposive and snowball techniques. The results from the systematic review show that for the transition to PM, we must first move from common medicine to stratified medicine and then PM. Moving toward PM requires strong economic, social, political, institutional, industrial, and, most importantly, technological infrastructures. These infrastructures will vary from country to country. In general, coexistence between the health system and PM technologies did not exist in the beginning, but it will emerge with its development. The resistance of the health system to accepting PM will gradually decrease. Furthermore, the government plays a key role in the early phases, while market and PM demand become more prominent during the development. New health actors will also develop PM, and out-of-date actors will be deleted or replaced. But moving toward PM is slightly different in Iran, particularly in the middle phases of transition.