Implementation of precision medicine in healthcare - a European perspective.

The technical development of high-throughput sequencing technologies and the parallel development of targeted therapies in the last decade have enabled a transition from traditional medicine to personalized treatment and care. In this way, by using comprehensive genomic testing, more effective treatments with fewer side effects are provided to each patient-i.e., precision, or personalized, medicine. In several European countries-such as in England, France and Denmark-the governments have adopted national strategies and taken "top-down" decisions to invest in national infrastructure for precision medicine. In other countries-such as Sweden and Germany, with regionally organized healthcare systems-the profession has instead taken "bottom-up" initiatives to build competence networks and infrastructure to enable equal access to precision medicine. In this review, we summarize key learnings at the European level on the implementation process to establish sustainable governance and organization for precision medicine at the regional, national and EU/international levels. We also discuss critical ethical and legal aspects of implementing precision medicine, and the importance of access to real-world data and performing clinical trials for evidence generation, as well as the need for improved reimbursement models, increased cross-disciplinary education and patient involvement. In summary, precision medicine represents a paradigm shift, and modernization of healthcare and all relevant stakeholders-i.e., healthcare, academia, policy makers, industry, and patients-must be involved in this system transformation, to create a sustainable, non-siloed ecosystem for precision healthcare that benefits our patients and society at large. This article is protected by copyright. All rights reserved.