A systematic review on the cost effectiveness of pharmacogenomics in developing countries: implementation challenges

Sukri, Asif; Salleh, Mohd Zaki; Masimirembwa, Collen; Kek, Teh Lay

doi:10.1038/s41397-022-00272-w

Cited by 10 publications

(7 citation statements)

References 61 publications

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“…Furthermore, the application of pharmacogenomics can be applied to reduce adverse events associated with treatment administered to patients. As the incidence of gastric cancer is more prevalent in low-and-middle-income countries compared to high income countries, it is challenging to implement personalized medicine in the region with low resources, although the implementation of pharmacogenomics has been demonstrated to be economically cost-effective in developing countries [ 115 ]. Thus, the prevention of gastric cancer through the early screening and eradication of H. pylori currently remains pertinent in low-and-middle income regions.…”

Section: Challenges To Associate the Immune System With Gastric Cancermentioning

confidence: 99%

The Roles of Immune Cells in Gastric Cancer: Anti-Cancer or Pro-Cancer?

Sukri

Hanafiah

Kosai

2022

Cancers

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Despite the fact that the incidence of gastric cancer has declined over the last decade, it is still the world’s leading cause of cancer-related death. The diagnosis of early gastric cancer is difficult, as symptoms of this cancer only manifest at a late stage of cancer progression. Thus, the prognosis of gastric cancer is poor, and the current treatment for improving patients’ outcomes involves the application of surgery and chemotherapy. Immunotherapy is one of the most recent therapies for gastric cancer, whereby the immune system of the host is programmed to combat cancer cells, and the therapy differs based upon the patient’s immune system. However, an understanding of the role of immune cells, namely the cell-mediated immune response and the humoral immune response, is pertinent for applications of immunotherapy. The roles of immune cells in the prognosis of gastric cancer have yielded conflicting results. This review discusses the roles of immune cells in gastric cancer pathogenesis, specifically, T cells, B cells, macrophages, natural killer cells, and dendritic cells, as well as the evidence presented thus far. Understanding how cancer cells interact with immune cells is of paramount importance in designing treatment options for gastric cancer immunotherapy.

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Section: Challenges To Associate the Immune System With Gastric Cancermentioning

confidence: 99%

The Roles of Immune Cells in Gastric Cancer: Anti-Cancer or Pro-Cancer?

Sukri

Hanafiah

Kosai

2022

Cancers

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“…In the majority of studies, the increased costs of genotyping were more than offset by the positive effects on patients’ life expectancy and quality of life [ 18 ], with the reduction of the risk of adverse drug reactions being a key benefit [ 19 ]. Nevertheless, some studies (e.g., [ 19 , 20 ]) show that the cost-effectiveness of implementing pharmacogenomics-guided drug use varies according to the diseases and types of drugs evaluated, which supports our choice of highlighting specific areas in the strategy document. Other studies mentioned cost-effectiveness evidence of using targeted massive parallel sequencing (MPS) as routine screening for allelic variants associated with maturity onset diabetes of the young [ 21 ] and the cost-effectiveness of an anticipatory intervention for asthmatics based on a relevant genetic abnormality [ 22 ].…”

Section: Results and Data Interpretationmentioning

confidence: 99%

Promoting advanced medical services in the framework of 3PM—a proof-of-concept by the “Centro” Region of Portugal

Regateiro,

Silva,

Lemos

et al. 2024

EPMA Journal

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Multidisciplinary team from three universities based in the “Centro” Region of Portugal developed diverse approaches as parts of a project dedicated to enhancing and expanding Predictive, Preventive, and Personalized Medicine (3PM) in the Region. In a sense, outcomes acted as a proof-of-concept, in that they demonstrated the feasibility, but also the relevance of the approaches. The accomplishments comprise defining a new regional strategy for implementing 3PM within the Region, training of human resources in genomic sequencing, and generating good practices handbooks dedicated to diagnostic testing via next-generation sequencing, to legal and ethical concerns, and to knowledge transfer and entrepreneurship, aimed at increasing literacy on 3PM approaches. Further approaches also included support for entrepreneurship development and start-ups, and diverse and relevant initiatives aimed at increasing literacy relevant to 3PM. Efforts to enhance literacy encompassed citizens across the board, from patients and high school students to health professionals and health students. This focus on empowerment through literacy involved a variety of initiatives, including the creation of an illustrated book on genomics and the production of two theater plays centered on genetics. Additionally, authors stressed that genomic tools are relevant, but they are not the only resources 3PM is based on. Thus, they defend that other initiatives intended to enable citizens to take 3PM should include multi-omics and, having in mind the socio-economic burden of chronic diseases, suboptimal health status approaches in the 3PM framework should also be considered, in order to anticipate medical intervention in the subclinical phase.

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“…Whilst the above discussion related to healthcare systems in high-income countries, the specific challenges in implementing PGx low- and middle-income countries need to be recognised – lack of clinical efficacy and effectiveness data, under-resourced clinical settings, socio-cultural issues and the identification of population specific pharmacogenomic markers (Tata et al, 2020 ; Magavern et al, 2022 ; Sukri et al, 2022 ). The lack of consistent and widely accepted definitions of race, ethnicity and ancestry in genomics and clinical research has resulted in erroneous, inconclusive or absent data on non-European ancestry populations (Popejoy et al, 2020 ).…”

Section: Pgx Implementationmentioning

confidence: 99%

Cardiovascular precision medicine – A pharmacogenomic perspective

Padmanabhan¹,

Toit²,

Dominiczak³

2023

Camb. prisms Precis. med.

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Precision medicine envisages the integration of an individual’s clinical and biological features obtained from laboratory tests, imaging, high-throughput omics and health records, to drive a personalised approach to diagnosis and treatment with a higher chance of success. As only up to half of patients respond to medication prescribed following the current one-size-fits-all treatment strategy, the need for a more personalised approach is evident. One of the routes to transforming healthcare through precision medicine is pharmacogenomics (PGx). Around 95% of the population is estimated to carry one or more actionable pharmacogenetic variants and over 75% of adults over 50 years old are on a prescription with a known PGx association. Whilst there are compelling examples of pharmacogenomic implementation in clinical practice, the case for cardiovascular PGx is still evolving. In this review, we shall summarise the current status of PGx in cardiovascular diseases and look at the key enablers and barriers to PGx implementation in clinical practice.

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A systematic review on the cost effectiveness of pharmacogenomics in developing countries: implementation challenges

Cited by 10 publications

References 61 publications

The Roles of Immune Cells in Gastric Cancer: Anti-Cancer or Pro-Cancer?

The Roles of Immune Cells in Gastric Cancer: Anti-Cancer or Pro-Cancer?

Promoting advanced medical services in the framework of 3PM—a proof-of-concept by the “Centro” Region of Portugal

Cardiovascular precision medicine – A pharmacogenomic perspective

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